BACKGROUND/ OBJECTIVES: Patients with congestive heart failure (CHF) have a high prevalence of cognitive impairment and the association is multifactorial. In general, the burden of anticholinergic drugs has consistently been shown to be a risk factor for cognitive impairment in the elderly. The aim of this study was to assess the cognitive burden of medications in patients with CHF. DESIGN: This was a cross-sectional, retrospective, single-center study. SETTING: The study was conducted in an outpatient setting. PARTICIPANTS: Patients who presented to a comprehensive heart failure clinic during a 1-month period were included. MEASUREMENTS: The primary outcomes of interest were mean anticholinergic cognitive burden (ACB) score of all medications and CHF medications (ACB-CHF), calculated based on the ACB Scoring Scale (ACB-SS). The ACB-CHF score was further dichotomized as 0 or 1 (low anticholinergic burden) versus 2 or 3 (high anticholinergic burden). RESULTS: A total of 182 patients were included. The mean ACB and ACB-CHF scores were 2.4 (range 0-13) and 1.0 (range 0-4), respectively, while 25.8 % of patients had an ACB-CHF score of 2 or 3. There was no association found between ejection fraction in patients with systolic heart failure and the ACB (p = 0.28) or ACB-CHF (p = 0.62) score. CONCLUSION: We conclude that patients with CHF have a substantial exposure to anticholinergic medications with adverse cognitive effects. This may be another important contributor to the increased prevalence of cognitive impairment in these patients.
BACKGROUND/ OBJECTIVES:Patients with congestive heart failure (CHF) have a high prevalence of cognitive impairment and the association is multifactorial. In general, the burden of anticholinergic drugs has consistently been shown to be a risk factor for cognitive impairment in the elderly. The aim of this study was to assess the cognitive burden of medications in patients with CHF. DESIGN: This was a cross-sectional, retrospective, single-center study. SETTING: The study was conducted in an outpatient setting. PARTICIPANTS: Patients who presented to a comprehensive heart failure clinic during a 1-month period were included. MEASUREMENTS: The primary outcomes of interest were mean anticholinergic cognitive burden (ACB) score of all medications and CHF medications (ACB-CHF), calculated based on the ACB Scoring Scale (ACB-SS). The ACB-CHF score was further dichotomized as 0 or 1 (low anticholinergic burden) versus 2 or 3 (high anticholinergic burden). RESULTS: A total of 182 patients were included. The mean ACB and ACB-CHF scores were 2.4 (range 0-13) and 1.0 (range 0-4), respectively, while 25.8 % of patients had an ACB-CHF score of 2 or 3. There was no association found between ejection fraction in patients with systolic heart failure and the ACB (p = 0.28) or ACB-CHF (p = 0.62) score. CONCLUSION: We conclude that patients with CHF have a substantial exposure to anticholinergic medications with adverse cognitive effects. This may be another important contributor to the increased prevalence of cognitive impairment in these patients.
Authors: Juho Uusvaara; Kaisu H Pitkala; Hannu Kautiainen; Reijo S Tilvis; Timo E Strandberg Journal: Drugs Aging Date: 2011-02-01 Impact factor: 3.923
Authors: Erin R Foster; Kathleen B Cunnane; Dorothy F Edwards; M Tracy Morrison; Gregory A Ewald; Edward M Geltman; Allyson R Zazulia Journal: Am J Occup Ther Date: 2011 May-Jun
Authors: Ingrid Kindermann; Denise Fischer; Julia Karbach; Andreas Link; Katrin Walenta; Christine Barth; Christian Ukena; Felix Mahfoud; Volker Köllner; Michael Kindermann; Michael Böhm Journal: Eur J Heart Fail Date: 2012-04 Impact factor: 15.534
Authors: Raymond L C Vogels; Philip Scheltens; Jutta M Schroeder-Tanka; Henry C Weinstein Journal: Eur J Heart Fail Date: 2006-12-14 Impact factor: 15.534
Authors: Noll Campbell; Malaz Boustani; Tony Limbil; Carol Ott; Chris Fox; Ian Maidment; Cathy C Schubert; Stephanie Munger; Donna Fick; David Miller; Rajesh Gulati Journal: Clin Interv Aging Date: 2009-06-09 Impact factor: 4.458
Authors: George A Heckman; Christopher J Patterson; Catherine Demers; Joye St Onge; Irene D Turpie; Robert S McKelvie Journal: Clin Interv Aging Date: 2007 Impact factor: 4.458