{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T07:10:59Z","timestamp":1772521859539,"version":"3.50.1"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Aging Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anticholinergic side effects of pharmacological treatment are a risk factor for cognitive decline in older people. Here, we aimed to assess the effect of anticholinergic burden of treatment on longitudinal rates of cognitive change and atrophy in functionally related brain regions in people from the Alzheimer\u2019s disease (AD) spectrum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We determined associations of anticholinergic burden of pharmacological treatment with rates of global cognition, episodic memory and executive function decline as well as basal forebrain and hippocampus atrophy in participants of the memory clinic based DELCODE cohort, spanning the range from cognitively normal through subjective cognitive decline, mild cognitive impairment and AD dementia. We had 794 cases with neuropsychological outcomes, and a subset of 703 cases with MRI outcomes. Effects were assessed using mixed effect models in a Bayesian framework using prior-insensitive cross-validated Bayes factors (CV-BF) and parameter estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We found moderate evidence for an association of anticholinergic burden with baseline levels of cognitive impairment for the PACC5 as a global cognitive function score (CV-BF\u202f=\u202f9.0) with more impairments with higher burden, but not with basal forebrain and hippocampus volumes, and weak evidence for an association of anticholinergic burden with longitudinal rates of change in the trail-making test B as an executive function score (CV-BF\u202f=\u202f2.5), but not for other cognitive scores and not for brain volumes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In the presence of prodromal or manifest AD, in a memory clinic-based cohort anticholinergic burden had only a modest effect on cognitive decline and no effect on atrophy in brain regions that are related to the cholinergic system.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnagi.2026.1751326","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T06:49:55Z","timestamp":1772520595000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of anticholinergic burden of medication with cognitive decline and longitudinal brain atrophy in the Alzheimer\u2019s disease spectrum"],"prefix":"10.3389","volume":"18","author":[{"given":"Stefan","family":"Teipel","sequence":"first","affiliation":[{"name":"German Center of Neurodegenerative Diseases (DZNE)","place":["Rostock\/Greifswald, Germany"]},{"name":"Department of Psychosomatic Medicine, University Medicine Rostock","place":["Rostock, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Grazia","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine, University Medicine Rostock","place":["Rostock, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Peters","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry and Psychotherapy, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin","place":["Berlin, Germany"]},{"name":"Department of Psychiatry and Psychotherapy, Charit\u00e9","place":["Berlin, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josef","family":"Priller","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry and Psychotherapy, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin","place":["Berlin, Germany"]},{"name":"Department of Psychiatry and Psychotherapy, Charit\u00e9","place":["Berlin, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anja","family":"Schneider","sequence":"additional","affiliation":[{"name":"Clinic of Old Age Psychiatry and Cognitive Disorders, University Hospital Bonn and University of Bonn","place":["Bonn, Germany"]},{"name":"German Center for Neurodegenerative Diseases (DZNE)","place":["Bonn, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Wiltfang","sequence":"additional","affiliation":[{"name":"German Center for Neurodegenerative Diseases (DZNE)","place":["Goettingen, Germany"]},{"name":"Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen","place":["Goettingen, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Bartels","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen","place":["Goettingen, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bj\u00f6rn Hendrik","family":"Schott","sequence":"additional","affiliation":[{"name":"German Center for Neurodegenerative Diseases (DZNE)","place":["Goettingen, Germany"]},{"name":"Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen","place":["Goettingen, Germany"]},{"name":"Department of Psychiatry and Psychotherapy, Otto-von-Guericke University","place":["Magdeburg, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Jessen","sequence":"additional","affiliation":[{"name":"German Center for Neurodegenerative Diseases (DZNE)","place":["Bonn, Germany"]},{"name":"Department of Psychiatry, Faculty of Medical, University of Cologne","place":["Cologne, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emrah","family":"Duezel","sequence":"additional","affiliation":[{"name":"German Center for Neurodegenerative Diseases (DZNE)","place":["Magdeburg, Germany"]},{"name":"Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University","place":["Magdeburg, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renat","family":"Yakupov","sequence":"additional","affiliation":[{"name":"German Center for Neurodegenerative Diseases (DZNE)","place":["Magdeburg, Germany"]},{"name":"Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University","place":["Magdeburg, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Buerger","sequence":"additional","affiliation":[{"name":"Department of Radiology, Ludwig Maximilian University Hospital","place":["Munich, Germany"]},{"name":"German Center for Neurodegenerative Diseases (DZNE, Munich)","place":["Munich, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Perneczky","sequence":"additional","affiliation":[{"name":"German Center for Neurodegenerative Diseases (DZNE, Munich)","place":["Munich, Germany"]},{"name":"Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich","place":["M\u00fcnchen, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Laske","sequence":"additional","affiliation":[{"name":"German Center for Neurodegenerative Diseases (DZNE)","place":["T\u00fcbingen, Germany"]},{"name":"Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of T\u00fcbingen","place":["T\u00fcbingen, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annika","family":"Spottke","sequence":"additional","affiliation":[{"name":"German Center for Neurodegenerative Diseases (DZNE)","place":["Bonn, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Wagner","sequence":"additional","affiliation":[{"name":"German Center for Neurodegenerative Diseases (DZNE)","place":["Bonn, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas","family":"Peltner","sequence":"additional","affiliation":[{"name":"German Center for Neurodegenerative Diseases (DZNE)","place":["Bonn, Germany"]},{"name":"Research Division, Federal Institute for Drugs and Medical Devices","place":["Bonn, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingo","family":"Kilimann","sequence":"additional","affiliation":[{"name":"German Center of Neurodegenerative Diseases (DZNE)","place":["Rostock\/Greifswald, Germany"]},{"name":"Department of Psychosomatic Medicine, University Medicine Rostock","place":["Rostock, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Britta","family":"Haenisch","sequence":"additional","affiliation":[{"name":"German Center for Neurodegenerative Diseases (DZNE)","place":["Bonn, Germany"]},{"name":"Research Division, Federal Institute for Drugs and Medical Devices","place":["Bonn, Germany"]},{"name":"Center for Translational Medicine, Medical Faculty, University of Bonn","place":["Bonn, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1016\/j.jalz.2011.03.008","article-title":"The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease","volume":"7","author":"Albert","year":"2011","journal-title":"Alzheimers 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