Influence of Drugs on Mild Cognitive Impairment in Parkinsons Disease:Evidence from the PACOS Study

• Published in: Current neuropharmacology 2022-01, Vol.20 (5), p.998-1003
• Main Authors: Cicero, Calogero Edoardo, Monastero, Roberto, Terravecchia, Claudio, Donzuso, Giulia, Luca, Antonina, Baschi, Roberta, Caccamo, Maria, Mostile, Giovanni, Giuliano, Loretta, Zappia, Mario, Nicoletti, Alessandra
• Format: Article
• Language: English
• Subjects: Aged; Cholinergic Antagonists - adverse effects; Cognitive Dysfunction - drug therapy; Humans; Middle Aged; Neurology; Neuropsychological Tests; Parkinson Disease - complications; Parkinson Disease - drug therapy; Parkinson Disease - psychology
• ISSN: 1570-159X; 1875-6190
• DOI: 10.2174/1570159X20666211223122800

Background: polytherapy and the anticholinergic activity of several drugs negatively influencecognition in the elderly. However, little is known on the effect on Mild Cognitive Impairment(MCI) in Parkinsons Disease (PD). Methods: patients with PD belonging to the baseline PACOS cohort with full pharmacological datahave been included in this study. MCI diagnosis was made according to the MDS level II criteria.Polytherapy was defined as patients assuming ≥6 drugs. The anticholinergic burden has been calculatedusing the Anticholinergic Drug Scale (ADS). Molecules have been classified according to theATC classification. Association with MCI has been assessed with a multivariate logistic regressionanalysis with MCI as the dependent variable. Results: pharmacological data were available for 238 patients (mean age 64.7±9.7). One hundred(42.0%) were diagnosed with MCI. No association was found in the full multivariate model (correctingfor age, sex, disease duration, education, UPDRS-ME, LEDD-DAs) with either polytherapyor the ADS. Concerning drug classes, anti-hypertensive medications were positively associated withPD-MCI (OR 2.02;95%CI 1.04-3.89; p=0.035) while gastroprotective agents were negatively associated(OR 0.51; 95%CI 0.27-0.99; p=0.047). Conclusion: the magnitude of polytherapy and anticholinergic drugs burden does not appear tomodulate MCI risk in PD, probably due to cautious prescription patterns. The effect of antihypertensiveand gastroprotective agents on PD-MCI risk, while needing further confirmations,could be relevant for clinical practice.