Title:Influence of Drugs on Mild Cognitive Impairment in Parkinson’s Disease:
Evidence from the PACOS Study
Volume: 20
Issue: 5
Author(s): Calogero Edoardo Cicero*, Roberto Monastero, Claudio Terravecchia, Giulia Donzuso, Antonina Luca, Roberta Baschi, Maria Caccamo, Giovanni Mostile, Loretta Giuliano, Mario Zappia and Alessandra Nicoletti*
Affiliation:
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, Section of Neurosciences, University
of Catania, Via Santa Sofia 78, Catania, Italy
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, Section of Neurosciences, University
of Catania, Via Santa Sofia 78, Catania, Italy
Keywords:
Parkinson’s disease, mild cognitive impairment, drugs, polytherapy, polypharmacy, anticholinergic burden.
Abstract:
Background: polytherapy and the anticholinergic activity of several drugs negatively influence
cognition in the elderly. However, little is known on the effect on Mild Cognitive Impairment
(MCI) in Parkinson’s Disease (PD).
Methods: patients with PD belonging to the baseline PACOS cohort with full pharmacological data
have been included in this study. MCI diagnosis was made according to the MDS level II criteria.
Polytherapy was defined as patients assuming ≥6 drugs. The anticholinergic burden has been calculated
using the Anticholinergic Drug Scale (ADS). Molecules have been classified according to the
ATC classification. Association with MCI has been assessed with a multivariate logistic regression
analysis with MCI as the dependent variable.
Results: pharmacological data were available for 238 patients (mean age 64.7±9.7). One hundred
(42.0%) were diagnosed with MCI. No association was found in the full multivariate model (correcting
for age, sex, disease duration, education, UPDRS-ME, LEDD-DAs) with either polytherapy
or the ADS. Concerning drug classes, anti-hypertensive medications were positively associated with
PD-MCI (OR 2.02;95%CI 1.04-3.89; p=0.035) while gastroprotective agents were negatively associated
(OR 0.51; 95%CI 0.27-0.99; p=0.047).
Conclusion: the magnitude of polytherapy and anticholinergic drugs burden does not appear to
modulate MCI risk in PD, probably due to cautious prescription patterns. The effect of antihypertensive
and gastroprotective agents on PD-MCI risk, while needing further confirmations,
could be relevant for clinical practice.
