The use of anticholinergic medications and the adoption of certain dietary patterns have both been implicated as a factor in cognitive impairment and Alzheimer disease (AD) in recent research.

The results of a two-year study involving 13,004 persons aged 65 years and older indicate that agents with anticholinergic activity increase the cumulative risk of cognitive impairment and mortality. At baseline, 47% of the subjects used a medication with possible anticholinergic properties and 4% used a drug with definite anticholinergic properties.

Study researcher Chris Fox, MD, and colleagues found that use of agents with definite anticholinergic effects was associated with a 0.33-point greater decline in Mini-Mental State Examination (MMSE) score compared with no anticholinergic use (published online ahead of print in Journal of the American Geriatrics Society). Use of possible anticholinergics at baseline was not associated with further decline.

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A separate study explored the links between diet and cognitive ability in 20 healthy adults and 29 with amnestic mild cognitive impairment (aMCI), in which the person experiences some memory problems. In a four-week trial, 24 participants followed a diet high in saturated fats and simple carbohydrates (HIGH diet); the remaining 25 followed a diet low in saturated fats and simple carbohydrates (LOW diet).

Among healthy adults eating the LOW diet, some biomarkers of AD seen in the cerebrospinal fluid (CSF) decreased, as did total cholesterol levels. However, the LOW diet raised levels of these biomarkers in the aMCI patients. In healthy adults, the HIGH diet moved CSF biomarkers “in a direction that may characterize a presymptomatic stage of AD,” reported the investigators (Arch Neurol. 2011;68:743-752).