Disparities in Cognitive Impairment With Anticholinergic Drug Use
Year: 2020
Type: article
Abstract: OBJECTIVES: We aim to evaluate the association between anticholinergic drug (ACH) use and cognitive impairment and the effect of disparity parameters (sex, race, income, education, and rural or urban areas) on this relationship. METHODS: The analyses included 13,623 adults aged ≥65 years from the REasons for Geographic And Racial Differences in Stroke study (recruited 2003-2007). The ACH use was defined by the 2015 Beers Criteria, and cognitive impairment was measured by the Six-Item Cognitive Screener. Multivariable logistic regression models assessed disparities in cognitive impairment with ACH use, iteratively adjusting for disparity parameters and other covariates. The full models included interaction terms between ACH use and other covariates. A similar approach was used for class-specific ACH exposure and cognitive impairment analyses. RESULTS: Approximately 14% of the participants used at least 1 ACH listed in the Beers Criteria. Antidepressants were the most frequently prescribed ACH class. A significant sex-race interaction illustrated that females compared with males (in Blacks: odds ratio [OR] = 1.28, 95% confidence interval [CI] 1.10-1.49 and in Whites: OR = 1.96, 95% CI 1.74-2.20), especially White females (Black vs White: OR = 0.71, 95% CI 0.64-0.80), were more likely to receive ACHs. Higher odds of cognitive impairment were observed among ACH users compared with the nonusers (OR = 1.26, 95% CI 1.01-1.58). In our class-level analyses, only antidepressant users (OR = 1.60, 95% CI 1.14-2.25) showed a significant association with cognitive impairment in the fully adjusted model. CONCLUSIONS: We observed demographic and socioeconomic differences in ACH use and in cognitive impairment, individually.
Source: Neurology Clinical Practice
Institutions: University of Alabama at Birmingham, Auburn University
Language: English
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W3084986879