The effect of anticholinergic drugs on cognition of patients with Parkinson's disease: a cohort study from the Egyptian population.

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Expert Review of Clinical Pharmacology Pub Date : 2024-08-01 Epub Date: 2024-05-30 DOI:10.1080/17512433.2024.2359955

Sherifa Ahmed Hamed, Ali Farrag El Hadad

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Abstract

Background: Cognitive dysfunction is a non-motor manifestation of Parkinson's disease (PD). We aimed to determine the frequency and patterns of cognitive dysfunction in treated patients with PD and their predictors.

Research design and methods: This study included 80 patients (male = 48; female = 32) and 30 healthy individuals. They underwent neuropsychiatric evaluations. Measurements included Beck's depression inventory - II (BDI-II), mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA).

Results: Patients had mean age of 55.56 ± 9.06 yrs, duration of PD of 4.86 ± 2.71 yrs and Hoehn and Yahr Scoring of 2.19 ± 0.89. They were on levodopa/carbidopa therapy and adjuvant therapy with benztropine mesylate, an anticholinergic drug, (n = 51) or amantadine sulfate, a dopaminergic drug, (n = 29). Sixteen (20%) had moderate depressive symptoms. Mild and moderate cognitive impairments were reported in 38.8% and 28.8% (by MMSE) and 46.3% and 31.3% (by MoCA). Patients had lower global cognitive scoring (p = 0.0001) and scorings of different cognitive functions (naming, attention, language, abstraction, memory and orientation) than controls. Patients treated with benztropine had lower cognition than with amantadine. Correlation analyses showed that lower cognition was only associated with chronic PD and its treatment (p = 0.0001).

Conclusions: Cognitive dysfunction is common with PD (77.5%) particularly with anticholinergic drugs. De-prescription of anticholinergics is recommended for patients with PD.

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抗胆碱能药物对帕金森病患者认知能力的影响：一项来自埃及人群的队列研究。

背景：认知功能障碍是帕金森病（PD）的一种非运动表现：认知功能障碍是帕金森病（PD）的一种非运动表现。我们旨在确定接受治疗的帕金森病患者出现认知功能障碍的频率和模式及其预测因素：本研究包括 80 名患者（男性 48 名；女性 32 名）和 30 名健康人。他们接受了神经精神病学评估。测量项目包括贝克抑郁量表-II（BDI-II）、小型精神状态检查（MMSE）和蒙特利尔认知评估（MoCA）：患者平均年龄为（55.56±9.06）岁，帕金森病病程为（4.86±2.71）年，Hoehn 和 Yahr 评分为（2.19±0.89）分。他们接受左旋多巴/卡比多巴治疗，并使用抗胆碱能药物甲磺酸苄托品（51人）或多巴胺能药物硫酸金刚烷胺（29人）辅助治疗。16人（20%）有中度抑郁症状。38.8%和28.8%的患者存在轻度和中度认知障碍（通过MMSE），46.3%和31.3%的患者存在轻度和中度认知障碍（通过MoCA）。与对照组相比，患者的总体认知评分（p = 0.0001）和不同认知功能（命名、注意力、语言、抽象、记忆和定向）的评分均较低。与金刚烷胺相比，接受苯扎托品治疗的患者认知能力更低。相关分析表明，认知能力较低仅与慢性帕金森病及其治疗有关（P = 0.0001）：结论：认知功能障碍在帕金森病中很常见（77.5%），尤其是使用抗胆碱能药物时。建议对帕金森病患者停用抗胆碱能药物。

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来源期刊

Expert Review of Clinical Pharmacology PHARMACOLOGY & PHARMACY-

CiteScore

7.30

自引率

2.30%

发文量

127

期刊介绍： Advances in drug development technologies are yielding innovative new therapies, from potentially lifesaving medicines to lifestyle products. In recent years, however, the cost of developing new drugs has soared, and concerns over drug resistance and pharmacoeconomics have come to the fore. Adverse reactions experienced at the clinical trial level serve as a constant reminder of the importance of rigorous safety and toxicity testing. Furthermore the advent of pharmacogenomics and ‘individualized’ approaches to therapy will demand a fresh approach to drug evaluation and healthcare delivery. Clinical Pharmacology provides an essential role in integrating the expertise of all of the specialists and players who are active in meeting such challenges in modern biomedical practice.