Objective: To explore utilization of anticholinergic medications using the Parkinson Foundation Quality Improvement Initiative (PF-QII) registry.

Background: Recent publications have highlighted the association between anticholinergic medication use and increased rates of dementia diagnoses. However, despite accumulating data on the negative cognitive impact of anticholinergics, these medications remain part of the treatment armamentarium in Parkinson’s disease (PD).

Method: Data were collected from the PF-QII registry, an international multi-center prospective study of PD care and outcomes at expert centers. Frequency of anticholinergic use in the cohort was analyzed, and characteristics of anticholinergic users and non-users were compared. Utilization rates of anticholinergics in patients with and without cognitive dysfunction were compared. Additionally, frequency of hospitalizations and ER visits (HER) was compared between anticholinergic users and non-users.

Results: 201 (3.4%) out of 5,949 patients were on anticholinergics at baseline visit. Compared to non-users, anticholinergic users tended to be younger (64.5±9.0 vs, 68.2±9.1, p<0.0001) and perform worse on immediate 5 word recall (4.2±1.0 vs 4.4±0.9, p=0.013). Among patients with and without cognitive dysfunction, 2.72% and 3.53% (p=0.21) were anticholinergic users, respectively. Among anticholinergic users and non-users, 38.3% and 43.4% (p=0.73) had HER, respectively.

Conclusion: Although there has been a decline in overall utilization of anticholinergics in the PD population, there remains persistent use of anticholinergics in patients with cognitive dysfunction. We additionally found that anticholinergic users performed worse on a cognitive task despite being younger than non-users. This highlights the need for greater education to improve clinicians’ prescribing practices for anticholinergics, given their potential for negative impact on cognition.

Poster presented at: American Academy of Neurology Annual Meeting; April 25, 2020; Toronto, ON, Canada.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/anticholinergic-use-in-parkinsons-disease-practice-patterns-in-patients-with-cognitive-impairment/