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@ARTICLE{Teipel:285730,
      author       = {Teipel, Stefan and Grazia, Alice and Peters, Oliver and
                      Priller, Josef and Schneider, Anja and Wiltfang, Jens and
                      Bartels, Claudia and Schott, Björn Hendrik and Jessen,
                      Frank and Duezel, Emrah and Yakupov, Renat and Buerger,
                      Katharina and Perneczky, Robert and Laske, Christoph and
                      Spottke, Annika and Wagner, Michael and Peltner, Jonas and
                      Kilimann, Ingo and Haenisch, Britta},
      title        = {{A}ssociations of anticholinergic burden of medication with
                      cognitive decline and longitudinal brain atrophy in the
                      {A}lzheimer's disease spectrum.},
      journal      = {Frontiers in aging neuroscience},
      volume       = {18},
      issn         = {1663-4365},
      address      = {Lausanne},
      publisher    = {Frontiers Research Foundation},
      reportid     = {DZNE-2026-00287},
      pages        = {1751326},
      year         = {2026},
      abstract     = {Anticholinergic 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.},
      keywords     = {Alzheimer’s disease (Other) / MRI (Other) / cholinergic
                      basal forebrain (Other) / hippocampus (Other) / treatement
                      (Other)},
      cin          = {AG Hänisch / AG Teipel / AG Schneider / AG Wiltfang / AG
                      Fischer / AG Jessen / AG Düzel / Clinical Research (Munich)
                      / AG Dichgans / AG Gasser / AG Spottke / AG Wagner},
      ddc          = {610},
      cid          = {I:(DE-2719)1013010 / I:(DE-2719)1510100 /
                      I:(DE-2719)1011305 / I:(DE-2719)1410006 / I:(DE-2719)1410002
                      / I:(DE-2719)1011102 / I:(DE-2719)5000006 /
                      I:(DE-2719)1111015 / I:(DE-2719)5000022 / I:(DE-2719)1210000
                      / I:(DE-2719)1011103 / I:(DE-2719)1011201},
      pnm          = {354 - Disease Prevention and Healthy Aging (POF4-354) / 353
                      - Clinical and Health Care Research (POF4-353) / 352 -
                      Disease Mechanisms (POF4-352)},
      pid          = {G:(DE-HGF)POF4-354 / G:(DE-HGF)POF4-353 /
                      G:(DE-HGF)POF4-352},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41853467},
      pmc          = {pmc:PMC12992049},
      doi          = {10.3389/fnagi.2026.1751326},
      url          = {https://pub.dzne.de/record/285730},
}