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Inhaled anticholinergics (LAMA\/SAMA) are central in COPD treatment. The link between COPD and dementia is well studied, while effects of COPD medications on survival in dementia patients, have received limited attention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Describe dementia patients using LAMA\/SAMA in the Swedish Dementia Registry (SveDem) and compare survival between users (exposed) and non-users (unexposed).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This register-based study used data from SveDem and the Swedish Prescribed Drug Register to identify dementia patients using inhaled anticholinergics. All patients diagnosed with dementia between 2008-01-01 and 2017-12-31 were included. Exposed patients had at least one LAMA\/SAMA dispensation per year in the two years prior the index date or more than one in the year before. Standardized-mortality-rates (SMR) were calculated, and survival analysed using Kaplan-Meier and Cox regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 74,018 dementia patients were included, of whom 3.5% had used inhaled anticholinergics. Alzheimer's disease was the most common dementia type. SMR was higher in exposed patients across all age groups: 8.21 versus 4.08 (ages 61\u201375) and 2.94 versus 1.84 (ages 75\u201390). Exposed had a higher risk of death (crude HR 1.73, 95% CI: 1.62\u20131.86) compared to unexposed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this register-based study we observed an association between inhaled anticholinergic use and reduced survival in dementia patients. This association is thought to be mainly driven by the underlying disease, COPD. Further studies are needed to clarify effects of inhaled anticholinergics on survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877251406309","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T16:11:05Z","timestamp":1765901465000},"page":"1306-1318","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Increased mortality in dementia patients using inhaled anticholinergics: A nationwide register study from the Swedish registry on dementia\/cognitive disorders, SveDem"],"prefix":"10.1177","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1934-9558","authenticated-orcid":false,"given":"Suzan","family":"Al-Mayahi","sequence":"first","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet and Clinical Pharmacology, Medical Diagnostics Karolinska, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marine L","family":"Andersson","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet and Clinical Pharmacology, Medical Diagnostics Karolinska, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minjia","family":"Mo","sequence":"additional","affiliation":[{"name":"Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Garcia-Ptacek","sequence":"additional","affiliation":[{"name":"Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden"},{"name":"Theme Inflammation and Aging, Medical unit Aging, Karolinska University Hospital, Huddinge, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7266-3431","authenticated-orcid":false,"given":"Hong","family":"Xu","sequence":"additional","affiliation":[{"name":"Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5569-0748","authenticated-orcid":false,"given":"Eva","family":"Wikstr\u00f6m","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet and Clinical Pharmacology, Medical Diagnostics Karolinska, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Eriksdotter","sequence":"additional","affiliation":[{"name":"Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden"},{"name":"Theme Inflammation and Aging, Medical unit Aging, Karolinska University Hospital, Huddinge, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,16]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines for chronic obstructive pulmonary disease https:\/\/goldcopd.org\/2023-gold-report-2\/ (2023)."},{"key":"e_1_3_3_3_2","volume-title":"Global Burden of Disease","author":"World Health Organization","year":"2020","unstructured":"World Health Organization. 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