Anticholinergic medications: An additional contributor to cognitive impairment in the heart failure population?

Arslan Shaukat, Amir Habib, Kathleen A. Lane, Changyu Shen, Saba Khan, Yaron M. Hellman, Malaz Boustani, Adnan S. Malik

Research output: Contribution to journalArticle

5 Scopus citations


Background/Objectives: Patients with congestive heart failure (CHF) have a high prevalence of cognitive impairment and the association is multifactorial. In general, the burden of anticholinergic drugs has consistently been shown to be a risk factor for cognitive impairment in the elderly. The aim of this study was to assess the cognitive burden of medications in patients with CHF. Design: This was a cross-sectional, retrospective, single-center study. Setting: The study was conducted in an outpatient setting. Participants: Patients who presented to a comprehensive heart failure clinic during a 1-month period were included. Measurements: The primary outcomes of interest were mean anticholinergic cognitive burden (ACB) score of all medications and CHF medications (ACB-CHF), calculated based on the ACB Scoring Scale (ACB-SS). The ACB-CHF score was further dichotomized as 0 or 1 (low anticholinergic burden) versus 2 or 3 (high anticholinergic burden). Results: A total of 182 patients were included. The mean ACB and ACB-CHF scores were 2.4 (range 0-13) and 1.0 (range 0-4), respectively, while 25.8 % of patients had an ACB-CHF score of 2 or 3. There was no association found between ejection fraction in patients with systolic heart failure and the ACB (p = 0.28) or ACB-CHF (p = 0.62) score. Conclusion: We conclude that patients with CHF have a substantial exposure to anticholinergic medications with adverse cognitive effects. This may be another important contributor to the increased prevalence of cognitive impairment in these patients.

Original languageEnglish (US)
Pages (from-to)749-754
Number of pages6
JournalDrugs and Aging
Issue number10
StatePublished - Oct 1 2014

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Pharmacology (medical)

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