Anticholinergic Drug Burden Higher in Patients With Parkinson Disease Dementia

An analysis of patients with Parkinson disease revealed a greater anticholinergic medication burden in those with Parkinson disease dementia. Researchers published their findings online ahead of print in the Polish Journal of Neurology and Neurosurgery.

The study included 338 patients with Parkinson disease at the Medical University of Silesia Department of Neurology in Poland between 2019 and 2021. Among them, 18.3%, or 62 patients, had Parkinson disease dementia.

Researchers assessed the anticholinergic drug burden for each patient using 2 scales: the Anticholinergic Cognitive Burden scale and the CRIDECO Anticholinergic Load Scale. On each scale, a score of 3 points or higher signals significant anticholinergic burden.

Among all patients in the study, 31.95% had significant anticholinergic burden per the CRIDECO Anticholinergic Load Scale, and 18.93% had significant anticholinergic burden per the Anticholinergic Cognitive Burden scale, researchers reported.

The group of patients with Parkinson disease dementia had a higher rate of significant anticholinergic burden compared with the group without dementia: 50% compared with 27.9% per the CRIDECO Anticholinergic Load Scale, and 43.5% compared with 13.41% per the Anticholinergic Cognitive Burden scale, the study found.

In addition to significant anticholinergic burden, patient age, disease severity per the Hoehn and Yahr scale, and atrial fibrillation were factors associated with Parkinson disease dementia.

Anticholinergic burden scales “are helpful in this risk assessment and might be crucial to avoid the development of Parkinson disease dementia, especially in older Parkinson disease patients with multimorbidities,” wrote corresponding author Joanna Siuda, MD, PhD, and coauthors from the Medical University of Silesia.

Reference: 
Malkiewicz JJ, Kasprzyk AG, Waksmudzki D, Węgrzynek J, Chmiela T, Siuda J. Risk factors for dementia in Parkinson’s disease - the overuse of anticholinergic drugs. Neurol Neurochir Pol. Published online June 26, 2023. doi:10.5603/PJNNS.a2023.0041