Objective: To examine the effect of chronic exposure to anticholinergics in a cohort of Alzheimer’s disease (AD) patients. Short-term exposure to anticholinergic medications exacerbates the cognitive deficits in AD. To date, no studies have examined the effects of long-term exposure to anticholinergics on disease progression.
Design: This study utilized a retrospective, parallel group design. The study population (n = 69) was divided into two groups: those receiving one or more concomitant medications with significant anticholinergic properties (n = 16) and those receiving no concomitant medications with anticholinergic properties (n = 53).
Materials and Methods: Participants were identified through the Emory University Alzheimer’s Disease Center (ADC) database. All participants were examined annually with standard neuropsychologic tests and received the cholinesterase inhibitor donepezil hydrochloride at a dose of 10 mg/day. T-tests for equality of means of independent samples was used to examine differences in MMSE scores between the two anticholinergic medication groups.
Results: At two years, MMSE scores were significantly worse for patients receiving anticholinergic medications compared to those not on anticholinergics (t-test for equality of means, t = 2.237, df = 34, p = 0.032).
Conclusion: While very preliminary, these data suggest that (1) concomitant therapy with anticholinergics may be associated with significant, deleterious effects on acetylcholinesterase therapy, or (2) more speculatively, that chronic exposure to anticholinergics may have adverse effects on the clinical course of Alzheimer’s disease.
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