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Of these patients, 694 were exposed to anticholinergic medications categorized as mild (reference group), and 538 were exposed to anticholinergic medications categorized as moderate or severe (exposure group).<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements and Main Results<\/jats:title><jats:p>Exposure to different types of anticholinergic medications was categorized by using the Anticholinergic Cognitive Burden (<jats:styled-content style=\"fixed-case\">ACB<\/jats:styled-content>) scale, and cumulative doses of anticholinergic medications were measured by using the cumulative minimum doses (<jats:styled-content style=\"fixed-case\">cMD<\/jats:styled-content>) method. Associations between anticholinergic medication use and risk of dementia were assessed by multivariable Cox proportional hazards models. The type of anticholinergics used (moderate or severe vs mild <jats:styled-content style=\"fixed-case\">ACB<\/jats:styled-content>) was not significantly associated with an increased risk of developing dementia (hazard ratio [<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>] 0.97, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 0.72\u20131.27). After adjusting for confounders, a high cumulative dose of anticholinergic drug (&gt;\u00a01095 cumulative minimum doses [<jats:styled-content style=\"fixed-case\">cMD<\/jats:styled-content>s]) was found to be significantly associated with an increased risk of developing dementia when compared with a low cumulative dose of anticholinergic drug (\u2264\u00a090 <jats:styled-content style=\"fixed-case\">cMD<\/jats:styled-content>s) (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 3.06, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.35\u20136.97).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among patients with Parkinson's disease in Taiwan, those with a high cumulative dose of anticholinergics had an increased risk of being diagnosed with dementia. Physicians should consider prescribing the lowest therapeutic dose of anticholinergic medication when making treatment decisions for patients with Parkinson's disease.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2305","type":"journal-article","created":{"date-parts":[[2019,6,28]],"date-time":"2019-06-28T12:55:31Z","timestamp":1561726531000},"page":"798-808","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Association between Anticholinergic Medication Use and Risk of Dementia among Patients with Parkinson's Disease"],"prefix":"10.1002","volume":"39","author":[{"given":"Jau\u2010Jiuan","family":"Sheu","sequence":"first","affiliation":[{"name":"Department of Neurology Taipei Medical University Hospital Taipei Taiwan"},{"name":"Department of Neurology School of Medicine College of Medicine Taipei Medical University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng\u2010Ting","family":"Tsai","sequence":"additional","affiliation":[{"name":"Medical Department Sanofi Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven R.","family":"Erickson","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy College of Pharmacy, University of Michigan Ann Arbor Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0495-1922","authenticated-orcid":false,"given":"Chung\u2010Hsuen","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Pharmacy College of Pharmacy Taipei Medical University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,17]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afr138"},{"key":"e_1_2_8_3_1","first-page":"101","article-title":"Trends in aging \u2013 United States and worldwide","volume":"52","author":"Centers for Disease Control and Prevention (CDC)","year":"2003","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1586\/14737175.2015.1038244"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(06)70373-8"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2009.186239"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2009.194548"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.3654"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pop.2015.01.005"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2007.10.016"},{"key":"e_1_2_8_11_1","first-page":"480260","article-title":"Treatment of advanced Parkinson's disease","volume":"2010","author":"Varanese S","year":"2011","journal-title":"Parkinsons Dis"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.229"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2011.03491.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.7663"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-010-0156-4"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k1315"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2011.03654.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2009.02258.x"},{"key":"e_1_2_8_19_1","unstructured":"National Health Research Institutes.National Health Insurance Research Database. 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