BMJ研究新闻:抗胆碱能药可增加老年人认知障碍的发生风险

2016-04-20 MedSci MedSci原创

据发表于JAMA Neurology的一项新的研究显示,许多常用的非处方药中含有抗胆碱能药物,如夜间感冒药,而抗胆碱能药物与老年人认知功能障碍的发生有关。

据发表于JAMA Neurology的一项新的研究显示,许多常用的非处方药中含有抗胆碱能药物,如夜间感冒药,而抗胆碱能药物与老年人认知功能障碍的发生有关。

既往研究已经发现,抗胆碱能药物可增加机体认知障碍和痴呆的发生风险。该研究共纳入了451名认知正常的老年人(平均年龄为73.3岁),这些研究对象来自于美国国家研究计划:阿尔茨海默病神经影像学研究和印第安纳记忆和衰老研究。其中60名(13%)研究对象服用至少一种中、高抗胆碱能活性的药物。通过大脑扫描分析研究人员探究了二者关联的潜在机制。

认知和记忆测试显示,与不服用抗胆碱能药物的患者相比,服用这些药物的患者短期记忆和执行功能测试中的平均得分较低。服用抗胆碱能药物的患者韦氏记忆量表修订版的逻辑记忆即时回忆测验平均得分明显低于不服用抗胆碱能药物的患者,对于他们的执行功能综合评分也是如此。

正电子发射断层扫描(PET)的结果显示,服用抗胆碱能药物的患者其葡萄糖的代谢降低,葡萄糖代谢是大脑活动的一个生物标志物。在海马区与记忆有关的区域活动性也降低,既往研究已证实这是阿尔茨海默氏症发生的早期表现。

磁共振成像(MRI)显示,脑结构和抗胆碱能药物的使用之间具有很大的关联。与不服用抗胆碱能药物的患者相比,服用抗胆碱能药物的患者的全皮质体积较小,而脑室却较大。

“这些研究发现使我们更好的理解了这类药物如何影响大脑从而增加机体认知障碍和痴呆发生风险,” 该研究的首席研究员,首席研究员、来自印第安纳波利斯印第安那大学健康科学中心的Shannon Risacher说道,“基于这些研究结果,在老年患者用药时医生或要开始考虑抗胆碱药物的替代药物。”

原始出处:

Susan Mayor. Common over-the-counter medicines are linked to cognitive impairment in elderly people, shows study. BMJ 2016; 353 doi: http://dx.doi.org/10.1136/bmj.i2220 (Published 19 April 2016)Cite this as: BMJ 2016;353:i2220.

Risacher SL, McDonald BC, Tallman EF, et al., Association between anticholinergic medication use and cognition, brain metabolism and brain atrophy in cognitively normal older adults. JAMA Neurol2016; published online Apr.doi:10.1001/jamaneurol.2016.0580.

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    2016-09-18 ylzr123

    赞一个!好文章拜读了,认真学习了。

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=130402, encodeId=6eec130402ba, content=赞一个!好文章拜读了,认真学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sun Sep 18 16:55:00 CST 2016, time=2016-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847963, encodeId=9cc8184e9637a, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Thu Oct 20 22:26:00 CST 2016, time=2016-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=83159, encodeId=e13183159cc, content=那要不要从年轻患者中就开始预防呢, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160307/IMG56DD346053F0D5538.jpg, createdBy=7bed1697174, createdName=那夏花开, createdTime=Thu Apr 28 09:29:00 CST 2016, time=2016-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82879, encodeId=b21d828e940, content=要少用这药, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0d231626576, createdName=jjzouyan, createdTime=Tue Apr 26 15:05:00 CST 2016, time=2016-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1527384, encodeId=1dac152e384cf, content=<a href='/topic/show?id=10b483495a2' target=_blank style='color:#2F92EE;'>#胆碱#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83495, encryptionId=10b483495a2, topicName=胆碱)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ce6211859522, createdName=grace5704, createdTime=Fri Apr 22 03:26:00 CST 2016, time=2016-04-22, status=1, ipAttribution=)]
    2016-10-20 gaoxiaoe
  3. [GetPortalCommentsPageByObjectIdResponse(id=130402, encodeId=6eec130402ba, content=赞一个!好文章拜读了,认真学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sun Sep 18 16:55:00 CST 2016, time=2016-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847963, encodeId=9cc8184e9637a, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Thu Oct 20 22:26:00 CST 2016, time=2016-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=83159, encodeId=e13183159cc, content=那要不要从年轻患者中就开始预防呢, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160307/IMG56DD346053F0D5538.jpg, createdBy=7bed1697174, createdName=那夏花开, createdTime=Thu Apr 28 09:29:00 CST 2016, time=2016-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82879, encodeId=b21d828e940, content=要少用这药, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0d231626576, createdName=jjzouyan, createdTime=Tue Apr 26 15:05:00 CST 2016, time=2016-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1527384, encodeId=1dac152e384cf, content=<a href='/topic/show?id=10b483495a2' target=_blank style='color:#2F92EE;'>#胆碱#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83495, encryptionId=10b483495a2, topicName=胆碱)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ce6211859522, createdName=grace5704, createdTime=Fri Apr 22 03:26:00 CST 2016, time=2016-04-22, status=1, ipAttribution=)]
    2016-04-28 那夏花开

    那要不要从年轻患者中就开始预防呢

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=130402, encodeId=6eec130402ba, content=赞一个!好文章拜读了,认真学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sun Sep 18 16:55:00 CST 2016, time=2016-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847963, encodeId=9cc8184e9637a, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Thu Oct 20 22:26:00 CST 2016, time=2016-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=83159, encodeId=e13183159cc, content=那要不要从年轻患者中就开始预防呢, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160307/IMG56DD346053F0D5538.jpg, createdBy=7bed1697174, createdName=那夏花开, createdTime=Thu Apr 28 09:29:00 CST 2016, time=2016-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=82879, encodeId=b21d828e940, content=要少用这药, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0d231626576, createdName=jjzouyan, createdTime=Tue Apr 26 15:05:00 CST 2016, time=2016-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1527384, encodeId=1dac152e384cf, content=<a href='/topic/show?id=10b483495a2' target=_blank style='color:#2F92EE;'>#胆碱#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83495, encryptionId=10b483495a2, topicName=胆碱)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ce6211859522, createdName=grace5704, createdTime=Fri Apr 22 03:26:00 CST 2016, time=2016-04-22, status=1, ipAttribution=)]
    2016-04-26 jjzouyan

    要少用这药

    0

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    2016-04-22 grace5704

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