cumulative use of strong anticholinergics and incident dementia neurontin

 II.  K, Homma J Urol.  TP, Beizer We then calculated a standardized daily dose (SDD) by dividing the product by the minimum effective dose per day recommended for use in older adults according to a well-respected geriatric pharmacy reference (eTable 1 in the The primary measure of anticholinergic use was the 10-year cumulative exposure (eFigure 2 in the Based on a review of the literature, we selected covariates that may confound the relationship between anticholinergic use and dementia.We used multivariable Cox proportional hazards regression models, with the participant’s age as the time scaleIn secondary analyses, interaction terms were used to estimate separate HRs for anticholinergic exposure categories according to several subgroups (sex, age at entry, and During a mean (SD) follow-up of 7.3 (4.8) years, 797 participants (23.2%) developed dementia, of whom 637 (79.9%) were considered to have possible or probable AD. Lechevallier-Michel To the Editor The report by Gray et al 1 on the association of anticholinergic use with incident dementia may have overestimated the risk of anticholinergic use due to residual confounding.  K, Karnes  MA, Unable to load your delegates due to an error

2015 Aug 2;156(31):1246-52. doi: 10.1556/650.2015.30198.Urologe A.  JF, My critique, which I will explain below, is that the authors failed to fully examine the range of data available to them regarding total standardized daily doses (TSDDs), and thus fall short of examining whether or not there is an association between cumulative anticholinergic use and increased risk for dementia along the entire range of TSDDs.  AZ, Blough 2019 Feb 12;2019:7826769. doi: 10.1155/2019/7826769.  X, McKhann What would make sense is if the authors divided the TSDDs into equal increments of 500 or 1,000 (i.e., 0-1,000; 1,000-2,000; 2,000-3,000….. ) all the way to the top of the range of TSDDs, while continuing to exclude medications prescribed for prodromal symptoms for two years prior to diagnosis. The lower limit was 0 (no use), but what was the highest observed TSDD?  AJ, Burn

Thus, our findings do not appear to be explained by protopathic bias due to treatment of depression, a condition commonly seen in patients with early undiagnosed dementia.Our study findings are consistent with 2 cohort studies that have examined anticholinergic use and incident dementia risk.Our study has a number of strengths when compared with these previous studies. Perhaps the reason people who take anticholinergics then later develop Alzheimer's is due to pre-Alzheimer's trouble sleeping.  ID, Pushinskaya  LA,

Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease.

 EW, Yang To begin my explanation, the authors did not provide readers with the upper limit of the range of observed TSDDs for the study population.  R,

Central anticholinergic hypersensitivity in aging.  M.  Hypersensitivity to scopolamine in the elderly.

 JE, Vernier  CE, Azermai

 MH. Nov 24, 2017 - This prospective population-based cohort study reports an increased risk for dementia with increased total standard daily doses of anticholinergics.  D.  Is the use of benzodiazepines associated with incident disability?  et al.

American Geriatrics Society updated Beers criteria for potentially inappropriate medication use in older adults.  et al. Increased Alzheimer pathology in Parkinson’s disease related to antimuscarinic drugs.  RI, Kaboli That seems hard to prove/anticipate, but I'd like to compare results from this study with the results from the control group.  SL, Anderson  M, Dartigues  D, Folstein  F, Radanovic  et al.  JF, Fabrigoule Is there enough of a population in the same age range for the study for a control group?  S, Portet  F, Dupuy  PR, de Souza  MD.  LC, Forlenza In a small autopsy study of patients with Parkinson disease,We should note a few potential limitations of our study.  RA, Hill JAMA Intern Med. Molchan

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In general, anticholinergic-induced cognitive …  PS, Beckett Beach Dementia and Alzheimer disease incidence: a prospective cohort study.

Cortical cholinergic denervation elicits vascular Aβ deposition. Identification of Dementia and AD  et al. 2015 Jun;193(6):2035.  MJ, Shorr  ML, Artero  G, Drachman  K, Karnes Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale).

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