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At enrollment, participants were free of known cardiovascular disease, major physical disability, or dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Cognitive assessments administered at baseline and biennially at follow\u2010up visits included the Modified Mini\u2010Mental State examination (3MS), Hopkins Verbal Learning Test\u2013Revised (HVLT\u2010R) delayed recall, Controlled Oral Word Association Test (COWAT), and Symbol Digit Modalities Test (SDMT). Anticholinergic burden was calculated at baseline using the Anticholinergic Cognitive Burden (ACB) scale and grouped as scores of 0 (no burden), 1\u20102 (low to moderate), or 3+ (high).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Results<\/jats:title>\n                    <jats:p>Linear mixed effects models were used to assess the relationship between ACB score and cognition over time. After adjusting for sex, age, education, minority status, smoking status, hypertension, diabetes, depression, chronic kidney disease, country, and frailty, participants with a high ACB score had worse performance over time for 3MS (Adjusted [Adj] B=\u20100.092, P=0.034), HVLT\u2010R delayed recall (Adj B=\u20100.104, P&lt;0.001), COWAT (Adj B=\u20100.151, P&lt;0.001), and SDMT (Adj B=\u20100.129, P=0.026), than participants with an ACB score of 0. A low to moderate ACB score was also associated with worse performance over time for HVLT\u2010R delayed recall (Adj B=\u20100.037, P=0.007) and COWAT (Adj B=\u20100.065, P=0.003), compared to those with no ACB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Anticholinergic burden predicts worse cognitive function over time in initially dementia\u2010free older adults, particularly for executive function (COWAT) and episodic memory (HVLT\u2010R).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/phar.2652","type":"journal-article","created":{"date-parts":[[2021,12,6]],"date-time":"2021-12-06T03:37:07Z","timestamp":1638761827000},"page":"134-144","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Anticholinergic medication burden and cognitive function in participants of the ASPREE 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