Anticholinergic drugs and the risk of dementia: A systematic review and meta-analysis

•Anticholinergic drug use is an independent risk factor for all-cause dementia and Alzheimer’s disease.•Heavier anticholinergic drug exposure is associated with a higher risk of dementia.•Different categories of anticholinergic drugs exert distinct effects on incident dementia.•It is important to ma...

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Published in:Neuroscience and biobehavioral reviews 2021-08, Vol.127, p.296-306
Main Authors: Zheng, Yong-Bo, Shi, Le, Zhu, Xi-Mei, Bao, Yan-Ping, Bai, Li-Juan, Li, Jin-Qiao, Liu, Jia-Jia, Han, Ying, Shi, Jie, Lu, Lin
Format: Article
Language:English
Subjects:
Anticholinergic drug
Dementia
Meta-analysis
Risk
Systematic review
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Summary:•Anticholinergic drug use is an independent risk factor for all-cause dementia and Alzheimer’s disease.•Heavier anticholinergic drug exposure is associated with a higher risk of dementia.•Different categories of anticholinergic drugs exert distinct effects on incident dementia.•It is important to manage and prescribe anticholinergic drugs to help optimize early prevention strategies for dementia. Dementia is one of the greatest global challenges for public health; however, the relationship between anticholinergic drugs and dementia remains unclear. The aim of the present study was to perform a systematic review and meta-analysis of the predictive roles of anticholinergic drugs in dementia risk. After pooling fourteen longitudinal and case-control studies with a total of 1,564,181 subjects, anticholinergic drug use was associated with an increased risk of all-cause dementia and Alzheimer’s disease. Both low and high anticholinergic drug burdens were associated with dementia. Moreover, there was a dose-dependent relationship between anticholinergic drugs and risk of dementia. With respect to the categories of anticholinergic drugs, antiparkinson, urological drugs, and antidepressants increased the risk for dementia; however, cardiovascular and gastrointestinal drugs played potentially protective roles. These findings underscore the importance of anticholinergic drugs as a potential modifiable risk factor for dementia and provide treatment priorities to optimize dementia prevention.
ISSN:0149-7634
1873-7528
DOI:10.1016/j.neubiorev.2021.04.031