Anticholinergics Have No Effect on Cognition in Parkinson’s

elderly man alone
elderly man alone
Parkinson's patients taking a high and lower level of anticholinergic medications showed no difference in cognition.

Contrary to previous evidence, anticholinergic drugs, frequently used in the elderly to treat conditions such as bladder dysfunction, do not negatively impact cognitive performance of patients with Parkinson’s disease (PD).

David J. Burn, MD, director of the Institute of Neuroscience and professor of movement disorder neurology at Newcastle University, England, and colleagues examined 195 Parkinson’s patients and 54 controls. The Parkinson’s subjects’ medication history, including over-the-counter drugs, was evaluated according to the Anticholinergic Drug Scale (ADS).

Each drug was classified on a scale from 0 to 3 according to no (0), mild (1), moderate (2), or high (3) anticholinergic activity. Usage from baseline to 18-month follow up was used to produce a total burden score. Those with ADS scores greater than or equal to 1 were in the PD+ADS group while those with ADS scores equal to 0 were designated PD-ADS.

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There were no differences between the two groups with respect to global cognition or assessments of attention, memory, and executive function at the end of 18 months, the researchers reported in the Journal of Parkinson’s Disease.

“This is the first study to explore an association between anticholinergic burden and mild cognitive impairment (MCI) in PD participants, and is timely given recent research demonstrating cumulative anticholinergic burden and risk of [Alzheimer’s disease] in the general population,” Dr Burn said in a statement.

“Our assessment will help determine whether patients prescribed medication with anticholinergic activity are more likely to develop dementia, and hence allow early targeted intervention to reduce future risk.”


Yarnall AJ, Lawson RA, Duncan GW, et al. Anticholinergic Load: Is there a Cognitive Cost in Early Parkinson’s Disease? J Parkinsons Dis. 2015;5(4):743-7.

This article originally appeared on Psychiatry Advisor