Influence of anticholinergic activity in serum on clinical symptoms of Alzheimer's disease

Koji Hori, Kimiko Konishi, Koichiro Watanabe, Hiroyuki Uchida, Takashi Tsuboi, Matsuko Moriyasu, Itaru Tominaga, Mitsugu Hachisu

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Alzheimer's disease (AD) is well known as a disease characterized by degeneration of cholinergic neuronal activity in the brain. It follows that patients with AD would be sensitive to an 'anticholinergic burden', and also that medicine with anticholinergic properties would promote various clinical symptoms of AD. Despite the relevance of this important phenomenon to the clinical therapeutics of AD patients, few reports have been seen concerning the relationship between anticholinergic burden and clinical AD symptoms. Therefore, we wished to investigate the relationship between serum anticholinergic activity (SAA) and the severity of clinical symptoms of AD patients. Twenty-six out of 76 AD patients referred by practitioners to our hospital were positive for anticholinergic activity in their serum, and the remaining 50 patients were negative. Cognitive and psychiatric symptoms in AD patients were compared between the positive SAA (SAA+) group and the negative SAA (SAA-) group. The SAA+ group showed a significantly (p < 0.05) lower total score on the Mini-Mental State Examination, and significantly (p < 0.05) higher scores on the Functional Assessment Staging and the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). In particular, certain subscales of the BEHAVE-AD, i.e. the items of paranoid and delusional ideation, hallucinations and diurnal rhythm disturbances, had higher scores in the SAA+ group. Moreover, it was shown that many more psychotropic medicines were prescribed to the SAA+ group. By means of logistic regression analysis, the items of paranoid and delusional ideation and diurnal rhythm disturbances in the BEHAVE-AD were positively correlated with SAA in patients. We hypothesized that SAA in AD patients would be associated with clinical symptoms, especially delusion and diurnal rhythm disturbances.

Original languageEnglish
Pages (from-to)147-153
Number of pages7
JournalNeuropsychobiology
Volume63
Issue number3
DOIs
Publication statusPublished - 2011 Feb

Fingerprint

Cholinergic Antagonists
Alzheimer Disease
Serum
Circadian Rhythm
Neurobehavioral Manifestations
Delusions
Hallucinations
Cholinergic Agents
Psychiatry

Keywords

  • Alzheimer's disease
  • Behavioral and psychological symptoms of dementia
  • Clinical symptoms
  • Serum anticholinergic activity

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Neuropsychology and Physiological Psychology
  • Biological Psychiatry

Cite this

Hori, K., Konishi, K., Watanabe, K., Uchida, H., Tsuboi, T., Moriyasu, M., ... Hachisu, M. (2011). Influence of anticholinergic activity in serum on clinical symptoms of Alzheimer's disease. Neuropsychobiology, 63(3), 147-153. https://doi.org/10.1159/000321591

Influence of anticholinergic activity in serum on clinical symptoms of Alzheimer's disease. / Hori, Koji; Konishi, Kimiko; Watanabe, Koichiro; Uchida, Hiroyuki; Tsuboi, Takashi; Moriyasu, Matsuko; Tominaga, Itaru; Hachisu, Mitsugu.

In: Neuropsychobiology, Vol. 63, No. 3, 02.2011, p. 147-153.

Research output: Contribution to journalArticle

Hori, K, Konishi, K, Watanabe, K, Uchida, H, Tsuboi, T, Moriyasu, M, Tominaga, I & Hachisu, M 2011, 'Influence of anticholinergic activity in serum on clinical symptoms of Alzheimer's disease', Neuropsychobiology, vol. 63, no. 3, pp. 147-153. https://doi.org/10.1159/000321591
Hori, Koji ; Konishi, Kimiko ; Watanabe, Koichiro ; Uchida, Hiroyuki ; Tsuboi, Takashi ; Moriyasu, Matsuko ; Tominaga, Itaru ; Hachisu, Mitsugu. / Influence of anticholinergic activity in serum on clinical symptoms of Alzheimer's disease. In: Neuropsychobiology. 2011 ; Vol. 63, No. 3. pp. 147-153.
@article{2b31bd5488e041969eefbc7913d9dfc9,
title = "Influence of anticholinergic activity in serum on clinical symptoms of Alzheimer's disease",
abstract = "Alzheimer's disease (AD) is well known as a disease characterized by degeneration of cholinergic neuronal activity in the brain. It follows that patients with AD would be sensitive to an 'anticholinergic burden', and also that medicine with anticholinergic properties would promote various clinical symptoms of AD. Despite the relevance of this important phenomenon to the clinical therapeutics of AD patients, few reports have been seen concerning the relationship between anticholinergic burden and clinical AD symptoms. Therefore, we wished to investigate the relationship between serum anticholinergic activity (SAA) and the severity of clinical symptoms of AD patients. Twenty-six out of 76 AD patients referred by practitioners to our hospital were positive for anticholinergic activity in their serum, and the remaining 50 patients were negative. Cognitive and psychiatric symptoms in AD patients were compared between the positive SAA (SAA+) group and the negative SAA (SAA-) group. The SAA+ group showed a significantly (p < 0.05) lower total score on the Mini-Mental State Examination, and significantly (p < 0.05) higher scores on the Functional Assessment Staging and the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). In particular, certain subscales of the BEHAVE-AD, i.e. the items of paranoid and delusional ideation, hallucinations and diurnal rhythm disturbances, had higher scores in the SAA+ group. Moreover, it was shown that many more psychotropic medicines were prescribed to the SAA+ group. By means of logistic regression analysis, the items of paranoid and delusional ideation and diurnal rhythm disturbances in the BEHAVE-AD were positively correlated with SAA in patients. We hypothesized that SAA in AD patients would be associated with clinical symptoms, especially delusion and diurnal rhythm disturbances.",
keywords = "Alzheimer's disease, Behavioral and psychological symptoms of dementia, Clinical symptoms, Serum anticholinergic activity",
author = "Koji Hori and Kimiko Konishi and Koichiro Watanabe and Hiroyuki Uchida and Takashi Tsuboi and Matsuko Moriyasu and Itaru Tominaga and Mitsugu Hachisu",
year = "2011",
month = "2",
doi = "10.1159/000321591",
language = "English",
volume = "63",
pages = "147--153",
journal = "Neuropsychobiology",
issn = "0302-282X",
publisher = "S. Karger AG",
number = "3",

}

TY - JOUR

T1 - Influence of anticholinergic activity in serum on clinical symptoms of Alzheimer's disease

AU - Hori, Koji

AU - Konishi, Kimiko

AU - Watanabe, Koichiro

AU - Uchida, Hiroyuki

AU - Tsuboi, Takashi

AU - Moriyasu, Matsuko

AU - Tominaga, Itaru

AU - Hachisu, Mitsugu

PY - 2011/2

Y1 - 2011/2

N2 - Alzheimer's disease (AD) is well known as a disease characterized by degeneration of cholinergic neuronal activity in the brain. It follows that patients with AD would be sensitive to an 'anticholinergic burden', and also that medicine with anticholinergic properties would promote various clinical symptoms of AD. Despite the relevance of this important phenomenon to the clinical therapeutics of AD patients, few reports have been seen concerning the relationship between anticholinergic burden and clinical AD symptoms. Therefore, we wished to investigate the relationship between serum anticholinergic activity (SAA) and the severity of clinical symptoms of AD patients. Twenty-six out of 76 AD patients referred by practitioners to our hospital were positive for anticholinergic activity in their serum, and the remaining 50 patients were negative. Cognitive and psychiatric symptoms in AD patients were compared between the positive SAA (SAA+) group and the negative SAA (SAA-) group. The SAA+ group showed a significantly (p < 0.05) lower total score on the Mini-Mental State Examination, and significantly (p < 0.05) higher scores on the Functional Assessment Staging and the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). In particular, certain subscales of the BEHAVE-AD, i.e. the items of paranoid and delusional ideation, hallucinations and diurnal rhythm disturbances, had higher scores in the SAA+ group. Moreover, it was shown that many more psychotropic medicines were prescribed to the SAA+ group. By means of logistic regression analysis, the items of paranoid and delusional ideation and diurnal rhythm disturbances in the BEHAVE-AD were positively correlated with SAA in patients. We hypothesized that SAA in AD patients would be associated with clinical symptoms, especially delusion and diurnal rhythm disturbances.

AB - Alzheimer's disease (AD) is well known as a disease characterized by degeneration of cholinergic neuronal activity in the brain. It follows that patients with AD would be sensitive to an 'anticholinergic burden', and also that medicine with anticholinergic properties would promote various clinical symptoms of AD. Despite the relevance of this important phenomenon to the clinical therapeutics of AD patients, few reports have been seen concerning the relationship between anticholinergic burden and clinical AD symptoms. Therefore, we wished to investigate the relationship between serum anticholinergic activity (SAA) and the severity of clinical symptoms of AD patients. Twenty-six out of 76 AD patients referred by practitioners to our hospital were positive for anticholinergic activity in their serum, and the remaining 50 patients were negative. Cognitive and psychiatric symptoms in AD patients were compared between the positive SAA (SAA+) group and the negative SAA (SAA-) group. The SAA+ group showed a significantly (p < 0.05) lower total score on the Mini-Mental State Examination, and significantly (p < 0.05) higher scores on the Functional Assessment Staging and the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). In particular, certain subscales of the BEHAVE-AD, i.e. the items of paranoid and delusional ideation, hallucinations and diurnal rhythm disturbances, had higher scores in the SAA+ group. Moreover, it was shown that many more psychotropic medicines were prescribed to the SAA+ group. By means of logistic regression analysis, the items of paranoid and delusional ideation and diurnal rhythm disturbances in the BEHAVE-AD were positively correlated with SAA in patients. We hypothesized that SAA in AD patients would be associated with clinical symptoms, especially delusion and diurnal rhythm disturbances.

KW - Alzheimer's disease

KW - Behavioral and psychological symptoms of dementia

KW - Clinical symptoms

KW - Serum anticholinergic activity

UR - http://www.scopus.com/inward/record.url?scp=78651230387&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78651230387&partnerID=8YFLogxK

U2 - 10.1159/000321591

DO - 10.1159/000321591

M3 - Article

C2 - 21228606

AN - SCOPUS:78651230387

VL - 63

SP - 147

EP - 153

JO - Neuropsychobiology

JF - Neuropsychobiology

SN - 0302-282X

IS - 3

ER -