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Two recent studies confirm the detrimental
effects of medications with anticholinergic properties in patients
with AD. Jewart et al measured cognition, function, and
behaviour in a small number of AD patients both on and off incontinence
medications with strong anticholinergic effects (oxybutynin
or tolterodine). Cognition as measured by the MMSE was significantly
worse when on these medications. In a slightly larger study,
Chew et al measured serum anticholinergic activity and
cognition in patients with moderate to severe dementia. There
was a significant correlation between increased serum anticholinergic
activity and worsened cognition, extending findings that have
been well documented in more mildly impaired dementia patients.
Cognitive, behavioral, and physiological
changes in Alzheimer disease patients as a function of incontine
(AM J GERIATR PSYCHIATRY 2005;13:324-328)
RITA D. JEWART, PHD,
JOANNE GREEN, PHD,
CHING-JU LU, MPH,
ET AL,
ATLANTA, GA
Serum anticholinergic activity and
cognition in patients with moderate-to-severe dementia
(AM J GERIATR PSYCHIATRY 2005;13:535-538)
MARCI L. CHEW, BS,
BENOIT H. MULSANT, MD,
BRUCE G. POLLOCK, MD,
FOR THE CONTINUATION
PHARMACOTHERAPY FOR
AGITATION OF DEMENTIA
(CPAD) STUDY GROUP
PITTSBURGH, PA
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