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Theses

Usage des médicaments anticholinergiques et fonctions cognitives « cohorte CONSTANCES »

Abstract : The relationship between the use of drugs with anticholinergic (AC) properties and cognitive function has been shown in several studies. However, these studies considered all the studied drugs as a homogeneous group without taking into consideration the AC potential and the therapeutic class. The population studied in our work is based on participants aged 45 and over in the CONSTANCES cohort who have undergone a battery of neuropsychological tests. Data concerning the dispensing of drugs with AC properties are extracted from the database of the French National System of Health Data (SNDS).The results of the first section of this work showed that the association between the use of drugs with AC properties and cognitive functions is heterogeneous across therapeutic classes. In addition, antipsychotics contribute to a large part of this association. Based on these results, the second section comparing psychotropic drugs with AC properties with those without, concluded that there is no substantial relationship between the AC activity of antidepressants and anxiolytics and cognitive functions. Thus, for these two therapeutic classes, the choice of drug based on its AC activity is not clinically relevant in terms of cognitive functioning. Our results are less clear for antipsychotics for which there may be a link between AC activity and lower executive functions. Finally, in the 3rd section we were able to develop a cognitive referential using a multidimensional approach. Analyses focusing on the impact of benzodiazepine (BZD) use on cognitive functions are detailed in this section.
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Submitted on : Monday, September 21, 2020 - 6:04:08 PM
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Abdelkrim Ziad. Usage des médicaments anticholinergiques et fonctions cognitives « cohorte CONSTANCES ». Médecine humaine et pathologie. Université Paris-Saclay, 2020. Français. ⟨NNT : 2020UPASV027⟩. ⟨tel-02944898⟩

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