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Cicero CE, Monastero R, Terravecchia C, et al. Influence of Drugs on Mild Cognitive Impairment in Parkinson's Disease: Evidence from the PACOS Study. Curr Neuropharmacol. 2021;doi: 10.2174/1570159X20666211223122800.
Cicero, C. E., Monastero, R., Terravecchia, C., Donzuso, G., Luca, A., Baschi, R., Caccamo, M., Mostile, G., Giuliano, L., Zappia, M., & Nicoletti, A. (2021). Influence of Drugs on Mild Cognitive Impairment in Parkinson's Disease: Evidence from the PACOS Study. Current neuropharmacology, . https://doi.org/10.2174/1570159X20666211223122800
Cicero, Calogero Edoardo, et al. "Influence of Drugs on Mild Cognitive Impairment in Parkinson's Disease: Evidence from the PACOS Study." Current neuropharmacology vol. (2021). doi: https://doi.org/10.2174/1570159X20666211223122800
Cicero CE, Monastero R, Terravecchia C, Donzuso G, Luca A, Baschi R, Caccamo M, Mostile G, Giuliano L, Zappia M, Nicoletti A. Influence of Drugs on Mild Cognitive Impairment in Parkinson's Disease: Evidence from the PACOS Study. Curr Neuropharmacol. 2021 Dec 23; doi: 10.2174/1570159X20666211223122800. Epub 2021 Dec 23. PMID: 34951389.
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Curr Neuropharmacol. 2021 Dec 23; doi: 10.2174/1570159X20666211223122800. Epub 2021 Dec 23.

Influence of Drugs on Mild Cognitive Impairment in Parkinson's Disease: Evidence from the PACOS Study.

Current neuropharmacology

Calogero Edoardo Cicero, Roberto Monastero, Claudio Terravecchia, Giulia Donzuso, Antonina Luca, Roberta Baschi, Maria Caccamo, Giovanni Mostile, Loretta Giuliano, Mario Zappia, Alessandra Nicoletti

Affiliations

  1. Department of Medical, Surgical sciences and Advanced technologies G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, Catania. Italy.
  2. Department of Biomedicine, Neuroscience and advanced Diagnostics, University of Palermo, Via La Loggia 1, 90129 Palermo. Italy.

PMID: 34951389 DOI: 10.2174/1570159X20666211223122800

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. 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 was available for 238 patients (mean age 64.7±9.7). One hundred (42.0%) were diagnosed as MCI. In the full multivariate model (correcting for age, sex, disease duration, education, UPDRS-ME, LEDD-DAs) no association was found with either polytherapy or the ADS. Concerning drug classes, anti-hypertensive medications increased the risk of PD-MCI (OR 2.02;95%CI 1.04-3.89; p=0.035) while gastroprotective agents had a protective effect (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 anti-hypertensive and gastroprotective agents on PD-MCI risk, while needing further confirmations, could be relevant for clinical practice.

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Keywords: Parkinson's disease; anticholinergic burden; drugs; mild cognitive impairment; polypharmacy; polytherapy

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