Anticholinergic medications: an additional contributor to cognitive impairment in the heart failure population?

Abstract:

BACKGROUND/OBJECTIVES:Patients with congestive heart failure (CHF) have a high prevalence of cognitive impairment and the association is multifactorial. In general, the burden of anticholinergic drugs has consistently been shown to be a risk factor for cognitive impairment in the elderly. The aim of this study was to assess the cognitive burden of medications in patients with CHF. DESIGN:This was a cross-sectional, retrospective, single-center study. SETTING:The study was conducted in an outpatient setting. PARTICIPANTS:Patients who presented to a comprehensive heart failure clinic during a 1-month period were included. MEASUREMENTS:The primary outcomes of interest were mean anticholinergic cognitive burden (ACB) score of all medications and CHF medications (ACB-CHF), calculated based on the ACB Scoring Scale (ACB-SS). The ACB-CHF score was further dichotomized as 0 or 1 (low anticholinergic burden) versus 2 or 3 (high anticholinergic burden). RESULTS:A total of 182 patients were included. The mean ACB and ACB-CHF scores were 2.4 (range 0-13) and 1.0 (range 0-4), respectively, while 25.8 % of patients had an ACB-CHF score of 2 or 3. There was no association found between ejection fraction in patients with systolic heart failure and the ACB (p = 0.28) or ACB-CHF (p = 0.62) score. CONCLUSION:We conclude that patients with CHF have a substantial exposure to anticholinergic medications with adverse cognitive effects. This may be another important contributor to the increased prevalence of cognitive impairment in these patients.

journal_name

Drugs Aging

journal_title

Drugs & aging

authors

Shaukat A,Habib A,Lane KA,Shen C,Khan S,Hellman YM,Boustani M,Malik AS

doi

10.1007/s40266-014-0204-2

subject

Has Abstract

pub_date

2014-10-01 00:00:00

pages

749-54

issue

10

eissn

1170-229X

issn

1179-1969

journal_volume

31

pub_type

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