A – 21 The Relationship between Anticholinergic Burden and Cognitive Performance in Veterans with and without Cognitive Diagnosis

Abstract Objective Anticholinergic burden (ACB) is associated with cognitive and functional impairment in older adults. ACB is related to global cognition and greater ACB can increase risk of dementia. Few studies examine the association between ACB and the memory profile in individuals with different levels of cognitive function. This study examined the relationship between Fox et al. (2011) ACB-score and memory and processing speed in veterans with and without cognitive diagnosis. Method Veterans (N=257; 90.3% male) who completed HVLT-R and had valid test performance were selected for inclusion. The sample was diverse (54.9% White, 30.0% Hispanic, 13.2% Black, 0.8% Indigenous, 1.2% Multi-racial) and older (M=66.03; SD=10.8). Other cognitive variables of interest included TMT-A and WAIS-IV Coding. Covarying for demographics, regression analyses examined the relationships between ACB-score and test scores. Analyses were conducted overall and across diagnosis groups (i.e., no neurocognitive disorder [no-NCD; n=114], mild-NCD/MCI [n=97], and major-NCD/dementia [n=46]). Chi-square examined association of ACB-risk across diagnostic groups. Results ACB-score and test scores were not correlated overall or within the no-NCD group. For mild-NCD/MCI, higher ACB-score predicted worse Coding (F[3,79]=6.277, p<.001; R2change=.057). For major-NCD/dementia, higher ACB-score predicted worse Coding (F[3,28]=3.524, p=.028; R2change=.207), TMT-A (F[3,28]=3.141, p=.036; R2change=.194), and HVLT-Discrimination (F[3,42]=3.211, p=.032; R2change=.136). Diagnostic groups had similar ACB-risk (χ2[2]=1.098, p=.578). Conclusion In veterans with normal cognition, ACB-score and cognitive performance were not associated. In veterans with MCI, higher ACB was associated with worse processing speed. For veterans with dementia, higher ACB was related to worse processing speed, delayed recall, and discrimination. For veterans with dementia, ACB may contribute to impairment