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@ARTICLE{Kilimann:163452,
      author       = {Kilimann, Ingo and Wucherer, Diana and Ittermann, Till and
                      Völzke, Henry and Bülow, Robin and Hoffmann, Wolfgang and
                      Grabe, Hans Jörgen and Wittfeld, Katharina and Teipel,
                      Stefan Johannes},
      title        = {{I}nverse association between the anticholinergic burden
                      and hippocampus volume in a population-based cohort across
                      the entire adult age range.},
      journal      = {GeroScience},
      volume       = {44},
      number       = {3},
      issn         = {2509-2723},
      address      = {[Cham]},
      publisher    = {Springer International Publishing},
      reportid     = {DZNE-2022-00212},
      pages        = {1715-1726},
      year         = {2022},
      note         = {(CC BY)},
      abstract     = {Many medications of different indications have a relevant
                      anticholinergic activity. The anticholinergic burden of
                      medication has been shown to have significant effects on the
                      cognition and the risk for cognitive impairment and dementia
                      particularly in older patients. So far, most of the studies
                      used data from geriatric patients and the effect of the
                      anticholinergic burden on brain structures is still
                      unexplored. Our study aimed to analyze possible associations
                      of hippocampus and cholinergic basal forebrain volumes as
                      vulnerable brain structures for the development of dementia
                      and the anticholinergic burden in a population-based cohort
                      of non-demented participants spanning the adult age range
                      from 21 to 80 years. We analyzed associations between
                      medication-related anticholinergic burden and structural MRI
                      volumes from participants (n = 3087, $52.2\%$ female) of the
                      population-based 'Study of Health in Pomerania' (SHIP).
                      Anticholinergic burden was obtained from the current
                      medication plan using the Anticholinergic Burden Scale
                      (ACB). All analyses were adjusted for age, sex, education,
                      and total intracranial volume. We found statistically
                      significant associations between the ACB and the left and
                      right hippocampus volume but not for the basal forebrain
                      cholinergic system. Complementary voxel-based analysis
                      across all participants revealed FWE-corrected (p = < 0.05)
                      clusters in the temporo-parietal regions reaching into
                      frontal areas, showing reduced volumes with higher ACB
                      scores. We identified an association between anticholinergic
                      burden of medication on hippocampal volume suggesting a
                      potential inverse effect of such medication. This
                      association highlights the importance of a careful
                      prescription of medication with anticholinergic activity at
                      any adult age.},
      keywords     = {Aged / Aged, 80 and over / Cholinergic Agents: therapeutic
                      use / Cholinergic Antagonists: adverse effects / Cognitive
                      Dysfunction: chemically induced / Cognitive Dysfunction:
                      diagnostic imaging / Cognitive Dysfunction: drug therapy /
                      Dementia / Female / Hippocampus: diagnostic imaging / Humans
                      / Male / Alzheimer’s disease (Other) / Cognitive
                      impairment (Other) / Hippocampus (Other) / Medication
                      (Other)},
      cin          = {AG Teipel / AG Thyrian / AG Grabe / AG Hoffmann},
      ddc          = {610},
      cid          = {I:(DE-2719)1510100 / I:(DE-2719)1510800 /
                      I:(DE-2719)5000001 / I:(DE-2719)1510600},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pmc          = {pmc:PMC9213601},
      pubmed       = {pmid:34940948},
      doi          = {10.1007/s11357-021-00497-w},
      url          = {https://pub.dzne.de/record/163452},
}