Are Anticholinergic Medications Associated With Increased Risk of Dementia and Behavioral and Psychological Symptoms of Dementia? A Nationwide 15-Year Follow-Up Cohort Study in Taiwan

Liu, Yia-Ping; Chien, Wu-Chien; Chung, Chi‐Hsiang; Chang, Hsin‐An; Kao, Yu Hsun; Tzeng, Nian‐Sheng

doi:10.3389/fphar.2020.00030

Cited by 26 publications

(25 citation statements)

References 87 publications

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“…The National health insurance (NHI) Program is a mandatory and universal health insurance program in Taiwan, which has been has been operative since 1995, that covered contracts with 97% of the medical providers with approximately 23 million beneficiaries, or more than 99% of the population 26 . The details of this program were documented in several previous studies [27][28][29][30][31][32][33][34][35][36][37] . The NHIRD contains comprehensive and detailed data regarding the total outpatients and inpatients.…”

Section: Data Sourcesmentioning

confidence: 99%

What could we learn from SARS when facing the mental health issues related to the COVID-19 outbreak? A nationwide cohort study in Taiwan

et al. 2020

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There were several studies about the psychiatric and mental health issues related to the severe adult respiratory syndrome (SARS) outbreak in 2003, however, the association between SARS and the overall risk of psychiatric disorders and suicides has, as yet, to be studied in Taiwan. The aim of this study is to examine as to whether SARS is associated with the risk of psychiatric disorders and suicide. A total of 285 patients with SARS and 2850 controls without SARS (1:10) matched for sex, age, insurance premium, comorbidities, residential regions, level of medical care, and index date were selected between February 25 and June 15, 2003 from the Inpatient Database Taiwan’s National Health Insurance Research Database. During the 12-year follow-up, in which 79 in the SARS cohort and 340 in the control group developed psychiatric disorders or suicide (4047.41 vs. 1535.32 per 100,000 person-years). Fine and Gray’s survival analysis revealed that the SARS cohort was associated with an increased risk of psychiatric disorders and suicide, and the adjusted subdistribution HR (sHR) was 2.805 (95% CI: 2.182–3.605, p < 0.001) for psychiatric disorders and suicide. The SARS cohort was associated with anxiety, depression, sleep disorders, posttraumatic stress disorder/acute stress disorder (PTSD/ASD), and suicide. The sensitivity analysis revealed that the SARS group was associated with anxiety, depression, sleep disorders, PTSD/ASD, and suicide after the individuals with a diagnosis of psychiatric disorders and suicide were excluded within the first year, and with anxiety, depression, and sleep disorders, while those in the first five years were excluded. In conclusion, SARS was associated with the increased risk of psychiatric disorders and suicide.

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Section: Data Sourcesmentioning

confidence: 99%

What could we learn from SARS when facing the mental health issues related to the COVID-19 outbreak? A nationwide cohort study in Taiwan

et al. 2020

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“…Regarding the possible risk of developing dementia following the intake of anticholinergic drugs, we found a recent study 20 which highlights a nonsignificant correlation between anticholinergic drugs and dementia, although this risk is reported in the literature. [21][22][23][24] The main differences between the previous studies concern the sample size of the population included, about 400 000 patients 20 compared to a much smaller number in the other studies, [22][23][24] to be a valid treatment for primary hyperhidrosis of axillary, facial/ gustatory, and palm-plantar sites. 25 Clinical trials investigating BTX-A use in axillary 26 and palmar hyperhidrosis 27 show significant benefits with few side effects reported, with a favorable impact also being seen on patient quality of life, whereas it has demonstrated to be less effective in the treatment of plantar hyperhidrosis.…”

Section: T a B L E 1 Age Gender Dlqi And Hdss In All Enrolled Patimentioning

confidence: 98%

Combined treatment of palmar hyperhidrosis with botulinum toxin type A and oxybutynin chloride: Results of a clinical, multicenter, prospective study

Campanati

Gregoriou

Consales

et al. 2020

Dermatologic Therapy

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Oxybutynin chloride and botulinum toxin type A (BTX-A) have demonstrated to be effective treatments for primary palmar hyperhidrosis (PPH); however, both of them are not completely free from local and/or generalized side effects. Primary aim of this study is to compare efficacy and safety of a sequencing administration of oral oxybutynin chloride after BTX-A injections vs oral oxybutynin chloride in monotherapy in patients with PPH. Secondary aim is to evaluate if the sequencing approach can allow the control of hyperhidrosis with lower dose of oral oxybutynin. Patients enrolled were compared for shortand long-term efficacy and safety of treatments. Effectiveness was evaluated through the Hyperhidrosis Disease Severity Scale (HDSS), and the Dermatology Life Quality Index (DLQI) score; safety was assessed through collection of the adverse events reported by patients both at baseline, at 24 and 52 weeks. Patients receiving sequencing treatment showed significant greater improvement than patients receiving oxybutynin chloride alone at T24 (HDSS P = .0076 and DLQI P = .0139) and T52 (HDSS P = .0387 and DLQI P = .0087). The dose of oxybutynin chloride useful to control hyperhidrosis was lower, and retention rate to the treatment was higher in patients receiving sequencing treatment (P = .001), than patients receiving monotherapy (P = .04). A sequencing therapeutic approach to palmar hyperhidrosis increases both efficacy and safety compared with the use of oral oxybutynin chloride alone, and allows clinicians to keep lower dosage of oxybutynin chloride reducing generalized side effects and increasing the retention rate to the treatment. K E Y W O R D S botulinum toxin type A, DLQI, HDSS, oxybutynin chloride, palmar hyperhidrosis 1 | INTRODUCTION Primary (idiopathic) focal hyperhidrosis is a disease characterized by an excessive sweating, beyond the body's physiological needs, and it has an important impact in quality of life. 1 Palm of hands, sole of feet, axilla, and face are the areas mainly affected. Primary hyperhidrosis differs from the secondary type, as it is not associated with underlying pathologies or to oral intake of medications; its onset can be during childhood and usually persists throughout adulthood. 2 According to the Canadian Hyperhidrosis Advisory Committee, the diagnosis of primary hyperhidrosis is essentially clinical and based

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“…The details of the program have been documented in previous studies. [24][25][26][27][28][29][30][31][32][33] This study was a retrospective matched-cohort design. Patients with ARD were selected from January 1 to December 31, 2000, according to the ICD-9-CM codes (Table S1) as: amphetamine dependence, amphetamine abuse, and drug psychosis between January 1, 2000 and December 31, 2000, without other substance use disorders within one year before or after the diagnosis of drug psychosis, with reference from one previous study.…”

Section: Study Design and Sampled Participantsmentioning

confidence: 99%

Association between amphetamine‐related disorders and dementia‐a nationwide cohort study in Taiwan

Tzeng

Chien

Chung

et al. 2020

Ann Clin Transl Neurol

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Objective We have conducted a study to clarify the association between amphetamine‐related disorders (ARD) and the risk of developing dementia. Methods This study used a retrospective cohort design by using Taiwan’s National Health Research Institute Database. A random sample of 68,300 subjects between January 1, 2000, and December 31, 2015, was obtained, comprising of 17,075 patients with ARD, and 51,225 controls without ARD (1:3), matched for gender and age group. After adjusting for covariates, a Fine and Gray’s survival analysis (competing with mortality) was used to compare the risk of dementia during a 15‐year follow‐up period. Results In the present study, 1,751 of 17,075 patients with ARD and 2,147 of 51,225 in the control group without ARD (883.10 vs 342.83 per 100,000 person‐years) developed dementia. ARD cohort was more likely to develop dementia (hazard ratio = 4.936 [95% CI: 4.609–5.285, P < 0.001). After adjusting for gender, age groups, education, monthly insured premiums, urbanization level, geographic region, comorbidities, the hazard ratio for ARD patients was 5.034 (95% CI: 4.701–5.391, P < 0.001). ARD has been associated with overall dementia, Alzheimer dementia, vascular dementia, and other dementia. Both the amphetamine use disorder and amphetamine‐induced psychotic disorders were associated with the risk of overall dementia, Alzheimer dementia, vascular dementia, and other dementia. Interpretation This study shows that patients with ARD, both the amphetamine use disorder and the amphetamine‐induced psychotic disorder, may have a nearly fivefold risk of developing dementia, including Alzheimer dementia and other types of dementia.

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Are Anticholinergic Medications Associated With Increased Risk of Dementia and Behavioral and Psychological Symptoms of Dementia? A Nationwide 15-Year Follow-Up Cohort Study in Taiwan

Cited by 26 publications

References 87 publications

What could we learn from SARS when facing the mental health issues related to the COVID-19 outbreak? A nationwide cohort study in Taiwan

What could we learn from SARS when facing the mental health issues related to the COVID-19 outbreak? A nationwide cohort study in Taiwan

Combined treatment of palmar hyperhidrosis with botulinum toxin type A and oxybutynin chloride: Results of a clinical, multicenter, prospective study

Association between amphetamine‐related disorders and dementia‐a nationwide cohort study in Taiwan

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