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Here we estimate the prevalence of anticholinergic use in England\u2019s older population in 1991 and 2011, and describe changes in use by participant\u2019s age, sex, cognition and disability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We compared data from participants aged 65+ years from the Cognitive Function and Ageing Studies (CFAS I and II), collected during 1990\u20131993 (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20097635) and 2008\u20132011 (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20097762). We estimated the prevalence of potent anticholinergic use (Anticholinergic Cognitive Burden [ACB] score\u2009=\u20093) and average anticholinergic burden (sum of ACB scores), using inverse probability weights standardised to the 2011 UK population. These were stratified by age, sex, Mini-Mental State Examination score, and activities of daily living (ADL) or instrumental ADL (IADL) disability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Prevalence of potent anticholinergic use increased from 5.7% (95% Confidence Interval [CI] 5.2\u20136.3%) of the older population in 1990\u201393 to 9.9% (9.3\u201310.7%) in 2008\u201311, adjusted odds ratio of 1.90 (95% CI 1.67\u20132.16). People with clinically significant cognitive impairment (MMSE [Mini Mental State Examination] 21 or less) were the heaviest users of potent anticholinergics in CFAS II (16.5% [95% CI 12.0\u201322.3%]). Large increases in the prevalence of the use medication with \u2018any\u2019 anticholinergic activity were seen in older people with clinically significant cognitive impairment (53.3% in CFAS I to 71.5% in CFAS II).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Use of potent anticholinergic medications nearly doubled in England\u2019s older population over 20\u2009years with some of the greatest increases amongst those particularly vulnerable to anticholinergic side-effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12877-020-01657-x","type":"journal-article","created":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T06:03:45Z","timestamp":1596175425000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":78,"title":["Increasing prevalence of anticholinergic medication use in older people in England over 20\u2009years: cognitive function and ageing study I and II"],"prefix":"10.1186","volume":"20","author":[{"given":"Carlota M.","family":"Grossi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Richardson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George M.","family":"Savva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Fox","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antony","family":"Arthur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoon K.","family":"Loke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Steel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Brayne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona E.","family":"Matthews","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phyo K.","family":"Myint","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4152-9704","authenticated-orcid":false,"given":"Ian D.","family":"Maidment","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,7,31]]},"reference":[{"key":"1657_CR1","volume-title":"Overview of the UK population: November 2018","author":"Office for National Statistics","year":"2018","unstructured":"Office for National Statistics. 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Ethical approval was obtained locally at all sites from 1991 and at Multi-centre research ethics committees <i>(CFAS I: REC99\/5\/22, 05\/MRE05\/37; CFAS II: 07\/MRE05\/48)<\/i> during the course of the study. For example, the first multi-centre ethical approval was obtained at the Anglia and Oxford multi-centre research ethics committee \u2013 part of the NHS REC (ref: 99\/5\/22). We requested the data from the CFAS National Coordinator. Data applications were reviewed by the Co-operative Management Committee (CMC) of CFAS. Datasets were created and released by CFAS Data Managers.Further detail on all ethical approvals can be found at:\n                      \n                      .Written informed consent was obtained from every participant. If the potential participant was considered to lack mental capacity, as per the Mental Capacity Act in the UK, assent was obtained from a key informant, usually a close family member. This method of consent was approved by an ethics committee.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Prof. Fox and Dr. Maidment received travel grants and Profs Fox and Myint received lecture fees from Astellas Pharma UK. Prof. Loke received consultancy fees from Thame Pharmaceuticals. All other authors report no conflict of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"267"}}