{"title":"个体抗胆碱能药物的认知作用:系统回顾和荟萃分析。","authors":"Amirreza Naseri, Saeed Sadigh-Eteghad, Sepideh Seyedi-Sahebari, Mohammad-Salar Hosseini, Sakineh Hajebrahimi, Hanieh Salehi-Pourmehr","doi":"10.1590/1980-5764-DN-2022-0053","DOIUrl":null,"url":null,"abstract":"<p><p>Anticholinergics (ACs) are among the most prescribed drugs. Investigating the impaired cognitive domains due to individual ACs usage is associated with controversial findings.</p><p><strong>Objective: </strong>The objective of this study was to investigate the effects of individual ACs on different aspects of cognitive function based on clinical trial studies.</p><p><strong>Methods: </strong>This systematic review was conducted following the PRISMA statement. A systematic search was performed in Embase, PubMed, Cochrane Library, Scopus, and Web of Science databases. Risk of bias (RoB) was assessed by the Joanna Briggs Institute checklists and the meta-analysis was performed using the CMA software.</p><p><strong>Results: </strong>Out of 3,026 results of searching, 138 studies were included. A total of 38 studies that assess the cognitive impacts of scopolamine were included in the meta-analysis. Included studies reported cognitive effects of scopolamine, mecamylamine, atropine, biperiden, oxybutynin, trihexyphenidyl, benzhexol, and dicyclomine; however, glycopyrrolate, trospium, tolterodine, darifenacin, fesoterodine, tiotropium, and ipratropium were not associated with cognitive decline. Based on the meta-analyses, scopolamine was associated with reduced recognition (SDM -1.84; 95%CI -2.48 to -1.21; p<0.01), immediate recall (SDM -1.82; 95%CI -2.35 to -1.30; p<0.01), matching to sample (SDM -1.76; 95%CI -2.57 to -0.96; p<0.01), delayed recall (SDM -1.54; 95%CI -1.97 to -1.10; p<0.01), complex memory tasks (SDM -1.31; 95%CI -1.78 to -0.84; p<0.01), free recall (SDM -1.18; 95%CI -1.63 to -0.73; p<0.01), cognitive function (SDM -0.95; 95%CI -1.46 to -0.44; p<0.01), attention (SDM -0.85; 95%CI -1.38 to -0.33; p<0.01), and digit span (SDM -0.65; 95%CI -1.21 to -0.10; p=0.02). There was a high RoB in our included study, especially in terms of dealing with possible cofounders.</p><p><strong>Conclusion: </strong>The limitations of this study suggest a need for more well-designed studies with a longer duration of follow-up on this topic to reach more reliable evidence.</p>","PeriodicalId":72777,"journal":{"name":"","volume":"17 ","pages":"e20220053"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10229087/pdf/","citationCount":"0","resultStr":"{\"title\":\"Cognitive effects of individual anticholinergic drugs: a systematic review and meta-analysis.\",\"authors\":\"Amirreza Naseri, Saeed Sadigh-Eteghad, Sepideh Seyedi-Sahebari, Mohammad-Salar Hosseini, Sakineh Hajebrahimi, Hanieh Salehi-Pourmehr\",\"doi\":\"10.1590/1980-5764-DN-2022-0053\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Anticholinergics (ACs) are among the most prescribed drugs. Investigating the impaired cognitive domains due to individual ACs usage is associated with controversial findings.</p><p><strong>Objective: </strong>The objective of this study was to investigate the effects of individual ACs on different aspects of cognitive function based on clinical trial studies.</p><p><strong>Methods: </strong>This systematic review was conducted following the PRISMA statement. A systematic search was performed in Embase, PubMed, Cochrane Library, Scopus, and Web of Science databases. Risk of bias (RoB) was assessed by the Joanna Briggs Institute checklists and the meta-analysis was performed using the CMA software.</p><p><strong>Results: </strong>Out of 3,026 results of searching, 138 studies were included. A total of 38 studies that assess the cognitive impacts of scopolamine were included in the meta-analysis. Included studies reported cognitive effects of scopolamine, mecamylamine, atropine, biperiden, oxybutynin, trihexyphenidyl, benzhexol, and dicyclomine; however, glycopyrrolate, trospium, tolterodine, darifenacin, fesoterodine, tiotropium, and ipratropium were not associated with cognitive decline. Based on the meta-analyses, scopolamine was associated with reduced recognition (SDM -1.84; 95%CI -2.48 to -1.21; p<0.01), immediate recall (SDM -1.82; 95%CI -2.35 to -1.30; p<0.01), matching to sample (SDM -1.76; 95%CI -2.57 to -0.96; p<0.01), delayed recall (SDM -1.54; 95%CI -1.97 to -1.10; p<0.01), complex memory tasks (SDM -1.31; 95%CI -1.78 to -0.84; p<0.01), free recall (SDM -1.18; 95%CI -1.63 to -0.73; p<0.01), cognitive function (SDM -0.95; 95%CI -1.46 to -0.44; p<0.01), attention (SDM -0.85; 95%CI -1.38 to -0.33; p<0.01), and digit span (SDM -0.65; 95%CI -1.21 to -0.10; p=0.02). There was a high RoB in our included study, especially in terms of dealing with possible cofounders.</p><p><strong>Conclusion: </strong>The limitations of this study suggest a need for more well-designed studies with a longer duration of follow-up on this topic to reach more reliable evidence.</p>\",\"PeriodicalId\":72777,\"journal\":{\"name\":\"\",\"volume\":\"17 \",\"pages\":\"e20220053\"},\"PeriodicalIF\":0.0,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10229087/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1590/1980-5764-DN-2022-0053\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1590/1980-5764-DN-2022-0053","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
抗胆碱能药(ACs)是最常用的处方药之一。由于个体使用ac而导致的认知领域受损的调查与有争议的发现有关。目的:本研究的目的是在临床试验研究的基础上,探讨个体ACs对认知功能不同方面的影响。方法:根据PRISMA声明进行系统评价。系统检索Embase、PubMed、Cochrane Library、Scopus和Web of Science数据库。偏倚风险(RoB)采用Joanna Briggs研究所的检查表进行评估,并使用CMA软件进行meta分析。结果:在3026个检索结果中,纳入了138个研究。荟萃分析共纳入了38项评估东莨菪碱对认知影响的研究。纳入的研究报告了东莨菪碱、甲胺、阿托品、双哌啶酮、奥昔布宁、三己苯醚、苯醚醇和二环明的认知作用;然而,甘罗酸酯、曲螺铵、托特罗定、达利那新、非索罗定、噻托溴铵和异丙托溴铵与认知能力下降无关。基于荟萃分析,东莨菪碱与认知能力下降相关(SDM -1.84;95%CI -2.48 ~ -1.21;结论:本研究的局限性提示需要更多设计良好、随访时间较长的研究,以获得更可靠的证据。
Cognitive effects of individual anticholinergic drugs: a systematic review and meta-analysis.
Anticholinergics (ACs) are among the most prescribed drugs. Investigating the impaired cognitive domains due to individual ACs usage is associated with controversial findings.
Objective: The objective of this study was to investigate the effects of individual ACs on different aspects of cognitive function based on clinical trial studies.
Methods: This systematic review was conducted following the PRISMA statement. A systematic search was performed in Embase, PubMed, Cochrane Library, Scopus, and Web of Science databases. Risk of bias (RoB) was assessed by the Joanna Briggs Institute checklists and the meta-analysis was performed using the CMA software.
Results: Out of 3,026 results of searching, 138 studies were included. A total of 38 studies that assess the cognitive impacts of scopolamine were included in the meta-analysis. Included studies reported cognitive effects of scopolamine, mecamylamine, atropine, biperiden, oxybutynin, trihexyphenidyl, benzhexol, and dicyclomine; however, glycopyrrolate, trospium, tolterodine, darifenacin, fesoterodine, tiotropium, and ipratropium were not associated with cognitive decline. Based on the meta-analyses, scopolamine was associated with reduced recognition (SDM -1.84; 95%CI -2.48 to -1.21; p<0.01), immediate recall (SDM -1.82; 95%CI -2.35 to -1.30; p<0.01), matching to sample (SDM -1.76; 95%CI -2.57 to -0.96; p<0.01), delayed recall (SDM -1.54; 95%CI -1.97 to -1.10; p<0.01), complex memory tasks (SDM -1.31; 95%CI -1.78 to -0.84; p<0.01), free recall (SDM -1.18; 95%CI -1.63 to -0.73; p<0.01), cognitive function (SDM -0.95; 95%CI -1.46 to -0.44; p<0.01), attention (SDM -0.85; 95%CI -1.38 to -0.33; p<0.01), and digit span (SDM -0.65; 95%CI -1.21 to -0.10; p=0.02). There was a high RoB in our included study, especially in terms of dealing with possible cofounders.
Conclusion: The limitations of this study suggest a need for more well-designed studies with a longer duration of follow-up on this topic to reach more reliable evidence.