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WMS 2020

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Medication effects, Alzheimer’s biomarkers and cognitive impairment in normal older adults


  • There is an increased risk of incident mild cognitive impairment (MCI) and decline in cognitively normal (CN) older adults on anticholinergic medications (aCH); these effects are significantly increased in individuals with genetic risk factors and cerebrospinal fluid (CSF)-based Alzheimer’s disease (AD) pathophysiologic markers.

Why this matters

  • Animal studies have demonstrated that cholinergic deprivation encourages plaque and tangle formation, neurodegeneration and accelerated decline in learning and memory.
  • Identifying modifiable risk factors for AD is increasingly important as there is a paucity of reliable treatments; as such, reducing or substituting aCH medications in older adults with genetic and CSF markers or risk factors may positively impact the growing prevalence of AD.

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