Concurrent use of anticholinergic drugs and acetylcholinesterase inhibitors in Alzheimer’s disease, and their association with the evolution of cognitive functions : Results from a retrospective study

Details

Supervisors

Schoevaerdts, Didier

Faculty

Faculté de médecine et médecine dentaire

Degree label

Master [180] en médecine

Abstract

The objective of this retrospective study was to examine the association between anticholinergic load, acetylcholinesterase inhibitors use and the evolution of cognitive functions in patients with Alzheimer’s disease. We also assessed the evolution of anticholinergic load in a 18-month period of follow-up using two different scales (ACB and MARANTE). Among 219 patients, followed in a geriatric day hospital, 105 (47%) were exposed to anticholinergic drugs, 156 patients were prescribed acetylcholinesterase inhibitors for the first time at baseline while 63 patients were already under acetylcholinesterase inhibitors therapy at baseline. Based on MMSE score at baseline, 117 patients had mild dementia and 102 had moderate dementia. We found that in patients receiving acetylcholinesterase inhibitors for the first time, the MMSE score was increased or stable during the first six months of follow-up, even in patients exposed to AC drugs. The potentially deleterious effect of anticholinergic exposure was only observed in patients with mild dementia and that were using acetylcholinesterase therapy before baseline. Similar results were obtained using both ACB and MARANTE scale despite the fact that only one third of all anticholinergic drugs reported in this study were shared by the scales. This study also revealed that the anticholinergic load remained stable in the 18-month follow-up, which represents, for the clinicians, a real opportunity to reconsider the prescription of drugs with anticholinergic properties.