Anticholinergic Medication Burden and Cognitive Subtypes in Parkinson’s Disease without Dementia

Congratulations to Drs.  Bhavana Patel, Ashley E Rawls, Michael S Okun, and Dawn Bowers on the publication of “Anticholinergic Medication Burden and Cognitive Subtypes in Parkinson’s Disease without Dementia,” which appears in the May issue of Clinical Neuropsychology.



Cognitive changes are heterogeneous in Parkinson’s disease (PD). This study compared whether anticholinergic burden drives differences in cognitive domain performance and empirically-derived PD-cognitive phenotypes.


A retrospective chart review contained participants (n = 493) who had idiopathic PD without dementia. Participants’ medications were scored (0–3) and summed based on the anticholinergic cognitive burden scale (ACBS). We examined the ACBS’ relationship to five cognitive domain composites (normative z-scores) and three (K-means clustering based) cognitive phenotypes: cognitively intact, low executive function (EF), and predominately impaired EF/memory. Analyses included Spearman correlations, analysis of covariance, and Pearson chi-squared test.


Overall, phenotypes did not differ in anticholinergic burden, and (after false-discovery-rate corrections) no cognitive domains related. When comparing those above and below the clinically relevant ACBS cutoff (i.e., score ≥3), no significant phenotype or domain differences were found.


Anticholinergic medication usage did not drive cognitive performance in a large clinical sample of idiopathic PD without dementia.