Anticholinergic Drug Burden and Neurocognitive Performance in the Study of Latinos-Investigation of Neurocognitive Aging

Article type: Research Article

Authors: Posis, Alexander Ivan B.^b | Tarraf, Wassim^{c; d} | Gonzalez, Kevin A.^e | Soria-Lopez, Jose A.^e | Léger, Gabriel C.^e | Stickel, Ariana M.^e | Daviglus, Martha L.^f | Lamar, Melissa^{f; g} | Zeng, Donglin^h | González, Hector M.^{e; *}

Affiliations: [a] Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA | [b] School of Public Health, San Diego State University, San Diego, CA, USA | [c] Institute of Gerontology, Wayne State University, Detroit, MI, USA | [d] Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA | [e] Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego, La Jolla, CA, USA | [f] Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, IL, USA | [g] Department of Psychiatry and Behavioral Sciences and Rush Alzheimer’s Disease Center, Rush, University Medical Center, Chicago, IL, USA | [h] Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA

Correspondence: [*] Correspondence to: Hector M. González, PhD, Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92161, USA. Tel.: +1 858 534 5361; E-mail: hmg002@health.ucsd.edu.

Abstract: Background:Studies of cumulative anticholinergic drug burden on cognitive function and impairment are emerging, yet few for Hispanics/Latinos. Objective:To examine associations between anticholinergic use and neurocognitive performance outcomes among diverse Hispanics/Latinos. Methods:This prospective cohort study included diverse Hispanic/Latino participants, enrolled in the Study of Latinos-Investigation of Neurocognitive, from New York, Chicago, Miami, and San Diego (n = 6,249). Survey linear regression examined associations between anticholinergic use (measured during baseline [Visit 1] and average 7-year follow up [Visit 2]) with global cognition, episodic learning, memory, phonemic fluency, processing speed, executive functioning, and average 7-year change. Results:Anticholinergic use was associated with lower cognitive global cognition (β= –0.21; 95% CI [–0.36; –0.05]), learning (β= –0.27; 95% CI [–0.47; –0.07]), memory (β= –0.22; 95% CI [–0.41; –0.03]), and executive functioning (β= –0.22; 95% CI [–0.40; –0.03]) scores, particularly among those who took anticholinergics at both visits. Anticholinergic use was associated with faster decline in global cognition, learning, and verbal fluency (β: –0.28 [95% CI: –0.55, –0.01]; β: –0.28 [95% CI: –0.55, –0.01]; β: –0.25, [95% CI –0.47, –0.04], respectively). Sex modified associations between anticholinergic use with global cognition, learning, and executive functioning (F3 = 3.59, F3 = 2.84, F3 = 3.88, respectively). Conclusion:Anticholinergic use was associated with lower neurocognitive performance, especially among those who used anticholinergics at both visits, among a study population of diverse Hispanics/Latinos. Findings will support evidence-based decisions regarding anticholinergic prescriptions and efforts to minimize cognitive impact.

Keywords: Aging, cognition, cognitive function, cohort study, neurocognitive tests, hispanics, latinos

DOI: 10.3233/JAD-215247

Journal: Journal of Alzheimer's Disease, vol. 86, no. 1, pp. 53-65, 2022