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Serum Anticholinergic Activity and Cognition in Patients With Moderate-to-Severe Dementia

Received January 8, 2004; revised April 2, May 17, June 4, 2004; accepted June 8, 2004. From the Division of Geriatrics and Neuropsychiatry, Department of Psychiatry, Univ. of Pittsburgh School of Medicine (MLC,BHM,BGP), the Dept. of Pharmaceutical Sciences, School of Pharmacy, Univ. of Pittsburgh (MLC), and the Geriatric Research, Education, and Clinical Center, VA Pittsburgh Health Care System (BHM). Send correspondence and reprint requests to Benoit H. Mulsant, M.D., Western Psychiatric Institute and Clinic, 3811 O’Hara St., Pittsburgh, PA 15213. e-mail: mulsantbh{at}upmc.edu
© 2005 American Association for Geriatric Psychiatry

Objective: The authors investigated the association between serum anticholinergic activity (SAA) and cognitive performance in a group of patients with moderate-to-severe dementia. Methods: SAA and cognitive performance were assessed in 26 patients admitted to a geropsychiatric unit for the treatment of behavioral disturbances associated with dementia. SAA was measured by radioreceptor competitive binding assay. Cognition was tested with the Mini-Mental State Exam and the Severe Impairment Battery. Results: Higher SAA was associated with lower cognitive performance. Conclusion: This study extends to patients with moderate-to-severe dementia the finding that higher SAA is associated with lower cognitive performance.

Key Words: Anticholinergics • Cognition • Dementia • Alzheimer Disease

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