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000285730 1001_ $$0P:(DE-2719)2000026$$aTeipel, Stefan$$b0$$eFirst author$$udzne
000285730 245__ $$aAssociations of anticholinergic burden of medication with cognitive decline and longitudinal brain atrophy in the Alzheimer's disease spectrum.
000285730 260__ $$aLausanne$$bFrontiers Research Foundation$$c2026
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000285730 520__ $$aAnticholinergic side effects of pharmacological treatment are a risk factor for cognitive decline in older people. Here, we aimed to assess the effect of anticholinergic burden of treatment on longitudinal rates of cognitive change and atrophy in functionally related brain regions in people from the Alzheimer's disease (AD) spectrum.We determined associations of anticholinergic burden of pharmacological treatment with rates of global cognition, episodic memory and executive function decline as well as basal forebrain and hippocampus atrophy in participants of the memory clinic based DELCODE cohort, spanning the range from cognitively normal through subjective cognitive decline, mild cognitive impairment and AD dementia. We had 794 cases with neuropsychological outcomes, and a subset of 703 cases with MRI outcomes. Effects were assessed using mixed effect models in a Bayesian framework using prior-insensitive cross-validated Bayes factors (CV-BF) and parameter estimates.We found moderate evidence for an association of anticholinergic burden with baseline levels of cognitive impairment for the PACC5 as a global cognitive function score (CV-BF = 9.0) with more impairments with higher burden, but not with basal forebrain and hippocampus volumes, and weak evidence for an association of anticholinergic burden with longitudinal rates of change in the trail-making test B as an executive function score (CV-BF = 2.5), but not for other cognitive scores and not for brain volumes.In the presence of prodromal or manifest AD, in a memory clinic-based cohort anticholinergic burden had only a modest effect on cognitive decline and no effect on atrophy in brain regions that are related to the cholinergic system.
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000285730 650_7 $$2Other$$aAlzheimer’s disease
000285730 650_7 $$2Other$$aMRI
000285730 650_7 $$2Other$$acholinergic basal forebrain
000285730 650_7 $$2Other$$ahippocampus
000285730 650_7 $$2Other$$atreatement
000285730 7001_ $$0P:(DE-2719)9001307$$aGrazia, Alice$$b1$$udzne
000285730 7001_ $$0P:(DE-2719)2811024$$aPeters, Oliver$$b2$$udzne
000285730 7001_ $$0P:(DE-2719)2811122$$aPriller, Josef$$b3$$udzne
000285730 7001_ $$0P:(DE-2719)2812035$$aSchneider, Anja$$b4$$udzne
000285730 7001_ $$0P:(DE-2719)2811317$$aWiltfang, Jens$$b5$$udzne
000285730 7001_ $$0P:(DE-2719)9000444$$aBartels, Claudia$$b6
000285730 7001_ $$0P:(DE-2719)2814326$$aSchott, Björn Hendrik$$b7$$udzne
000285730 7001_ $$0P:(DE-2719)2000032$$aJessen, Frank$$b8$$udzne
000285730 7001_ $$0P:(DE-2719)2000005$$aDuezel, Emrah$$b9$$udzne
000285730 7001_ $$0P:(DE-2719)2812398$$aYakupov, Renat$$b10$$udzne
000285730 7001_ $$0P:(DE-2719)2811351$$aBuerger, Katharina$$b11$$udzne
000285730 7001_ $$0P:(DE-2719)2812234$$aPerneczky, Robert$$b12$$udzne
000285730 7001_ $$0P:(DE-2719)2000055$$aLaske, Christoph$$b13$$udzne
000285730 7001_ $$0P:(DE-2719)2811324$$aSpottke, Annika$$b14$$udzne
000285730 7001_ $$0P:(DE-2719)2000057$$aWagner, Michael$$b15$$udzne
000285730 7001_ $$0P:(DE-2719)9002192$$aPeltner, Jonas$$b16$$udzne
000285730 7001_ $$0P:(DE-2719)2810394$$aKilimann, Ingo$$b17$$udzne
000285730 7001_ $$0P:(DE-2719)2810511$$aHaenisch, Britta$$b18$$eLast author$$udzne
000285730 773__ $$0PERI:(DE-600)2558898-9$$a10.3389/fnagi.2026.1751326$$gVol. 18, p. 1751326$$p1751326$$tFrontiers in aging neuroscience$$v18$$x1663-4365$$y2026
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