H55 Anticholinergic drug burden and cognitive function in huntington’s disease


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Abstract

BackgroundIndividuals with Huntington’s disease may present with difficulties in cognition. Cognition affects an individual’s care needs, including the need for residential care.1 Medical comorbidities compound difficulties for those with HD and their caregivers. Psychotropic and other medications may have significant anticholinergic side effects,2 these may be cumulative in nature and affect cognition. The Drug Burden Index (DBI)3 4 is a measure of exposure to anticholinergic medications. It was reported to be independently associated with physical and cognitive function in community dwelling older persons.ObjectiveSpecific Aim 1: Does anticholinergic drug burden score impact cognitive function? Specific Aim 2: What is the role of psychotropic medications in generating this anticholinergic burden?MethodsDe-identified data was obtained from the Enroll-HD and Registry Specified Dataset. Medication data is maintained by the Uppsala Monitoring Centre (UMC). We will combine this data with psychometric tests available. DBI will be calculated at years 1 (baseline), 2 and 4. A measure of the area under the curve for DBI (AUCDB) over the whole study period will be calculated.Results3000 Cognitive assessments were identified ranging from 1 to 4 years of follow up in the dataset. MMSE scores varied from 2 to 30. Data examination revealed significant co-morbidities, which will be correlated with Drug Burden Index scores.ConclusionThe effects and burden of anticholinergic medicines in individuals with Huntington’s disease is significant. The impact of the anticholinergic burden score upon cognitive function must be carefully monitored. All medications should be regularly reviewed to maximize cognitive function.References. Kolanowski A, Fick DM, Campbell J, Litaker M, Boustani M. Preliminary study of anticholinergic burden and relationship to a quality of life indicator, engagement in activities, in nursing home residents with dementia. Journal of the American Medical Directors Association2009;10(4):252–257.. Cardwell K, Hughes CM, Ryan C. The association between anticholinergic medication burden and health related outcomes in the ‘oldest old’: a systematic review of the literature. Drugs Aging2015;32(10):835–48.. Hilmer SN, Mager DE, Simonsick EM, Ling SM, Windham BG, Harris TB, Shorr RI,Bauer DC, Abernethy DR. Drug burden index score and functional decline in older people. The American Journal Of Medicine2009;122(12):1142–1149.e1–2.. Unti E, Mazzucchi S, Palermo G, Bonuccelli U, Ceravolo R. Antipsychotic drugs in Huntington’s disease. Expert Review of Neurotherapeutics2017March;17(3):227–237, 11p.

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