Subjective Memory Complaints in Older Adults: The Role of Polypharmacy and Anticholinergic Burden

Abstract

Background

Subjective memory complaints (SMC) are common in older adults and may indicate an increased risk of cognitive decline. Polypharmacy and anticholinergic burden have been associated with cognitive impairment, but their specific contribution to SMC remains unclear. The aim of this study was to investigate the association between polypharmacy, anticholinergic burden and SMC in community-dwelling older adults.

Methods

This cross-sectional study included 652 participants aged 65 years and older from geriatric outpatient clinics. SMC was assessed via a structured clinician-administered question, and cognitive function was evaluated using the Mini-Mental State Examination (MMSE). Polypharmacy was defined as the concomitant use of five or more medications, while anticholinergic burden was determined using the Anticholinergic Burden Classification (ABC). Logistic regression models were used to examine the independent effects of polypharmacy and anticholinergic burden on SMC, adjusting for demographic variables, comorbidities and depressive symptoms.

Results

SMC was reported by 48% of participants. Polypharmacy (OR = 2.10, 95% CI: 1.43-3.08, P < 0.001) and higher anticholinergic burden (OR = 2.39, 95% CI: 1.72-3.32, P < 0.001) were independently associated with increased SMC. Chronic obstructive pulmonary disease (COPD) was also identified as a significant predictor (OR = 2.90, 95% CI: 1.41-5.98, P = 0.004).

Conclusion

Polypharmacy and anticholinergic burden are significant risk factors for SMC in older adults. Reducing unnecessary medication use and minimizing anticholinergic burden may help to alleviate cognitive complaints. Future longitudinal studies are needed to determine causal relationships and possible interventions.