Abstract
Alzheimer's disease is a common cause of dementia and is usually treated with medications that elevate acetylcholine levels. The objective of this study was to identify drugs with anticholinergic properties prescribed to patients diagnosed with Alzheimer's disease in Colombia. Design: A cross-sectional study. Setting and participants: the study was conducted in outpatients diagnosed with Alzheimer's disease who were identified from a population database from Colombia and had been treated with cholinesterase inhibitors and glutamate NMDA receptor antagonists. Measures: The anticholinergic burden was evaluated using the Anticholinergic Cognitive Burden (ACB) scale, and patients were classified on a scale of 0-3 points according to anticholinergic potential. The study included 4134 Alzheimer's disease patients. The mean age was 81.50±8.16 years, and 67.8% were women. At least 22.9% of patients took anticholinergic drugs, including 32 different drugs. Of these, the most frequently prescribed medication was quetiapine (8.6%). A total of 78.4% of patients were receiving pharmacological treatment for Alzheimer's disease. Cholinesterase inhibitors were prescribed to 45.9% of patients, while memantine was prescribed for 27.4% of patients. The concomitant use of the two drugs was observed in 5.2% of cases. Age greater than 85 years was associated with a 119% risk of having an anticholinergic burden ≥3 points (OR 2.197, 95% CI: 1.159-4.162, p: 0.016). Potential interactions between cholinesterase inhibitors and anticholinergic drugs were identified in 7.8% of patients. The majority of patients who were prescribed anticholinergic drugs were elderly women, had a significant total anticholinergic burden and had frequent pharmacological interactions with cholinesterase inhibitors. The use of anticholinergics reduces the clinical effectiveness of antidementia drugs and increases the risk of adverse reactions.
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