Anticholinergic Medication Burden and Cognitive Subtypes in Parkinson’s Disease without Dementia
Abstract Objective Cognitive changes are heterogeneous in Parkinson’s disease (PD). This study compared whether anticholinergic burden drives differences in cognitive domain performance and empirically-derived PD-cognitive phenotypes. Method A retrospective chart review contained participants (n = 4...
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| Veröffentlicht in: | Archives of clinical neuropsychology 2024-11, Vol.39 (8), p.1443-1449 |
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| container_title | Archives of clinical neuropsychology |
| container_volume | 39 |
| creator | Santos, Lauren G Kenney, Lauren E Ray, Alyssa Paredes, Alfredo Ratajska, Adrianna M Eversole, Kara Patel, Bhavana Rawls, Ashley E Okun, Michael S Bowers, Dawn |
| description | Abstract
Objective
Cognitive changes are heterogeneous in Parkinson’s disease (PD). This study compared whether anticholinergic burden drives differences in cognitive domain performance and empirically-derived PD-cognitive phenotypes.
Method
A retrospective chart review contained participants (n = 493) who had idiopathic PD without dementia. Participants’ medications were scored (0–3) and summed based on the anticholinergic cognitive burden scale (ACBS). We examined the ACBS’ relationship to five cognitive domain composites (normative z-scores) and three (K-means clustering based) cognitive phenotypes: cognitively intact, low executive function (EF), and predominately impaired EF/memory. Analyses included Spearman correlations, analysis of covariance, and Pearson chi-squared test.
Results
Overall, phenotypes did not differ in anticholinergic burden, and (after false-discovery-rate corrections) no cognitive domains related. When comparing those above and below the clinically relevant ACBS cutoff (i.e., score ≥3), no significant phenotype or domain differences were found.
Conclusions
Anticholinergic medication usage did not drive cognitive performance in a large clinical sample of idiopathic PD without dementia. |
| doi_str_mv | 10.1093/arclin/acae041 |
| format | Article |
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Objective
Cognitive changes are heterogeneous in Parkinson’s disease (PD). This study compared whether anticholinergic burden drives differences in cognitive domain performance and empirically-derived PD-cognitive phenotypes.
Method
A retrospective chart review contained participants (n = 493) who had idiopathic PD without dementia. Participants’ medications were scored (0–3) and summed based on the anticholinergic cognitive burden scale (ACBS). We examined the ACBS’ relationship to five cognitive domain composites (normative z-scores) and three (K-means clustering based) cognitive phenotypes: cognitively intact, low executive function (EF), and predominately impaired EF/memory. Analyses included Spearman correlations, analysis of covariance, and Pearson chi-squared test.
Results
Overall, phenotypes did not differ in anticholinergic burden, and (after false-discovery-rate corrections) no cognitive domains related. When comparing those above and below the clinically relevant ACBS cutoff (i.e., score ≥3), no significant phenotype or domain differences were found.
Conclusions
Anticholinergic medication usage did not drive cognitive performance in a large clinical sample of idiopathic PD without dementia.</description><identifier>ISSN: 1873-5843</identifier><identifier>EISSN: 1873-5843</identifier><identifier>DOI: 10.1093/arclin/acae041</identifier><identifier>PMID: 38797973</identifier><language>eng</language><publisher>United States: Oxford University Press</publisher><subject>Aged ; Aged, 80 and over ; Cholinergic Antagonists - adverse effects ; Cognition - drug effects ; Cognitive Dysfunction - chemically induced ; Cognitive Dysfunction - etiology ; Dementia ; Executive Function - drug effects ; Executive Function - physiology ; Female ; Humans ; Male ; Middle Aged ; Neuropsychological Tests - statistics & numerical data ; Parkinson Disease - complications ; Parkinson Disease - drug therapy ; Retrospective Studies</subject><ispartof>Archives of clinical neuropsychology, 2024-11, Vol.39 (8), p.1443-1449</ispartof><rights>The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2024</rights><rights>The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c214t-abe3ed73345b0a028e9967f990e070fd5b45be1c26931f5c7eb618d4d739b8e23</cites><orcidid>0000-0003-0454-1704</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38797973$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Santos, Lauren G</creatorcontrib><creatorcontrib>Kenney, Lauren E</creatorcontrib><creatorcontrib>Ray, Alyssa</creatorcontrib><creatorcontrib>Paredes, Alfredo</creatorcontrib><creatorcontrib>Ratajska, Adrianna M</creatorcontrib><creatorcontrib>Eversole, Kara</creatorcontrib><creatorcontrib>Patel, Bhavana</creatorcontrib><creatorcontrib>Rawls, Ashley E</creatorcontrib><creatorcontrib>Okun, Michael S</creatorcontrib><creatorcontrib>Bowers, Dawn</creatorcontrib><title>Anticholinergic Medication Burden and Cognitive Subtypes in Parkinson’s Disease without Dementia</title><title>Archives of clinical neuropsychology</title><addtitle>Arch Clin Neuropsychol</addtitle><description>Abstract
Objective
Cognitive changes are heterogeneous in Parkinson’s disease (PD). This study compared whether anticholinergic burden drives differences in cognitive domain performance and empirically-derived PD-cognitive phenotypes.
Method
A retrospective chart review contained participants (n = 493) who had idiopathic PD without dementia. Participants’ medications were scored (0–3) and summed based on the anticholinergic cognitive burden scale (ACBS). We examined the ACBS’ relationship to five cognitive domain composites (normative z-scores) and three (K-means clustering based) cognitive phenotypes: cognitively intact, low executive function (EF), and predominately impaired EF/memory. Analyses included Spearman correlations, analysis of covariance, and Pearson chi-squared test.
Results
Overall, phenotypes did not differ in anticholinergic burden, and (after false-discovery-rate corrections) no cognitive domains related. When comparing those above and below the clinically relevant ACBS cutoff (i.e., score ≥3), no significant phenotype or domain differences were found.
Conclusions
Anticholinergic medication usage did not drive cognitive performance in a large clinical sample of idiopathic PD without dementia.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cholinergic Antagonists - adverse effects</subject><subject>Cognition - drug effects</subject><subject>Cognitive Dysfunction - chemically induced</subject><subject>Cognitive Dysfunction - etiology</subject><subject>Dementia</subject><subject>Executive Function - drug effects</subject><subject>Executive Function - physiology</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neuropsychological Tests - statistics & numerical data</subject><subject>Parkinson Disease - complications</subject><subject>Parkinson Disease - drug therapy</subject><subject>Retrospective Studies</subject><issn>1873-5843</issn><issn>1873-5843</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkLtOwzAUhi0EoqWwMiKPMKS141zH0nKTikAC5shxTlpDYgfbAXXjNXg9noRUKYgNneEc6Xz_N_wIHVMypiRlE25EJdWECw4koDtoSJOYeWESsN0_9wAdWPtMCAkp9ffRgCVx2g0bonyqnBQr3UnALKXAt1BIwZ3UCp-3pgCFuSrwTC-VdPIN8EObu3UDFkuF77l5kcpq9fXxafFcWuAW8Lt0K906PIcaOjk_RHslrywcbfcIPV1ePM6uvcXd1c1suvCETwPn8RwYFDFjQZgTTvwE0jSKyzQlQGJSFmHePYAKP0oZLUMRQx7RpAi6SJon4LMROu29jdGvLViX1dIKqCquQLc2YyQicdBJN-i4R4XR1hoos8bImpt1Rkm26TXre822vXaBk627zWsofvGfIjvgrAd02_wn-wahE4ZX</recordid><startdate>20241122</startdate><enddate>20241122</enddate><creator>Santos, Lauren G</creator><creator>Kenney, Lauren E</creator><creator>Ray, Alyssa</creator><creator>Paredes, Alfredo</creator><creator>Ratajska, Adrianna M</creator><creator>Eversole, Kara</creator><creator>Patel, Bhavana</creator><creator>Rawls, Ashley E</creator><creator>Okun, Michael S</creator><creator>Bowers, Dawn</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0454-1704</orcidid></search><sort><creationdate>20241122</creationdate><title>Anticholinergic Medication Burden and Cognitive Subtypes in Parkinson’s Disease without Dementia</title><author>Santos, Lauren G ; Kenney, Lauren E ; Ray, Alyssa ; Paredes, Alfredo ; Ratajska, Adrianna M ; Eversole, Kara ; Patel, Bhavana ; Rawls, Ashley E ; Okun, Michael S ; Bowers, Dawn</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c214t-abe3ed73345b0a028e9967f990e070fd5b45be1c26931f5c7eb618d4d739b8e23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cholinergic Antagonists - adverse effects</topic><topic>Cognition - drug effects</topic><topic>Cognitive Dysfunction - chemically induced</topic><topic>Cognitive Dysfunction - etiology</topic><topic>Dementia</topic><topic>Executive Function - drug effects</topic><topic>Executive Function - physiology</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neuropsychological Tests - statistics & numerical data</topic><topic>Parkinson Disease - complications</topic><topic>Parkinson Disease - drug therapy</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Santos, Lauren G</creatorcontrib><creatorcontrib>Kenney, Lauren E</creatorcontrib><creatorcontrib>Ray, Alyssa</creatorcontrib><creatorcontrib>Paredes, Alfredo</creatorcontrib><creatorcontrib>Ratajska, Adrianna M</creatorcontrib><creatorcontrib>Eversole, Kara</creatorcontrib><creatorcontrib>Patel, Bhavana</creatorcontrib><creatorcontrib>Rawls, Ashley E</creatorcontrib><creatorcontrib>Okun, Michael S</creatorcontrib><creatorcontrib>Bowers, Dawn</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of clinical neuropsychology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Santos, Lauren G</au><au>Kenney, Lauren E</au><au>Ray, Alyssa</au><au>Paredes, Alfredo</au><au>Ratajska, Adrianna M</au><au>Eversole, Kara</au><au>Patel, Bhavana</au><au>Rawls, Ashley E</au><au>Okun, Michael S</au><au>Bowers, Dawn</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anticholinergic Medication Burden and Cognitive Subtypes in Parkinson’s Disease without Dementia</atitle><jtitle>Archives of clinical neuropsychology</jtitle><addtitle>Arch Clin Neuropsychol</addtitle><date>2024-11-22</date><risdate>2024</risdate><volume>39</volume><issue>8</issue><spage>1443</spage><epage>1449</epage><pages>1443-1449</pages><issn>1873-5843</issn><eissn>1873-5843</eissn><abstract>Abstract
Objective
Cognitive changes are heterogeneous in Parkinson’s disease (PD). This study compared whether anticholinergic burden drives differences in cognitive domain performance and empirically-derived PD-cognitive phenotypes.
Method
A retrospective chart review contained participants (n = 493) who had idiopathic PD without dementia. Participants’ medications were scored (0–3) and summed based on the anticholinergic cognitive burden scale (ACBS). We examined the ACBS’ relationship to five cognitive domain composites (normative z-scores) and three (K-means clustering based) cognitive phenotypes: cognitively intact, low executive function (EF), and predominately impaired EF/memory. Analyses included Spearman correlations, analysis of covariance, and Pearson chi-squared test.
Results
Overall, phenotypes did not differ in anticholinergic burden, and (after false-discovery-rate corrections) no cognitive domains related. When comparing those above and below the clinically relevant ACBS cutoff (i.e., score ≥3), no significant phenotype or domain differences were found.
Conclusions
Anticholinergic medication usage did not drive cognitive performance in a large clinical sample of idiopathic PD without dementia.</abstract><cop>United States</cop><pub>Oxford University Press</pub><pmid>38797973</pmid><doi>10.1093/arclin/acae041</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-0454-1704</orcidid></addata></record> |
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| ispartof | Archives of clinical neuropsychology, 2024-11, Vol.39 (8), p.1443-1449 |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE |
| subjects | Aged Aged, 80 and over Cholinergic Antagonists - adverse effects Cognition - drug effects Cognitive Dysfunction - chemically induced Cognitive Dysfunction - etiology Dementia Executive Function - drug effects Executive Function - physiology Female Humans Male Middle Aged Neuropsychological Tests - statistics & numerical data Parkinson Disease - complications Parkinson Disease - drug therapy Retrospective Studies |
| title | Anticholinergic Medication Burden and Cognitive Subtypes in Parkinson’s Disease without Dementia |
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