Risk of Mild Cognitive Impairment and Its Relation to Anticholinergics Revealed Within Screening in a Community Pharmacy

Abstract Background The increasing prevalence of cognitive impairments (CI), such as Alzheimer's disease and dementia, requires a multidisciplinary approach to prevention. Brief cognitive screening in community pharmacies can help identify CI in early stages, within advanced pharmaceutical care, and effectively reduce the workload of ambulatory care. Study objectives were to assess the association between patients' cognitive ability as determined by standardised cognitive screening and the presence of modifiable Dementia Risk factors, as well as at-risk medication use related to CI within pharmaceutical counselling in community pharmacies. Methods Data collection was realised between 2018 and 2019, retrospective analysis 2024–2025. This study retrospectively analysed data from a clinical cohort study (N = 323). A score expressed cognitive abilities in a short version of the Montreal Cognitive Assessment (s-MoCA), with a cut-off score of ≤ 12 for CI. Dementia risk factors were assessed according to the Cardiovascular Risk Factors, Ageing, and Incidence of Dementia (CAIDE) Risk Score and the cumulative effect of at-risk medications with anticholinergic activity on a person's cognitive function by the Anticholinergic Cognitive Burden Scale (c-ACB). Results Within the provision of pharmaceutical service, 80.50% (N = 260) of respondents were identified with lower cognitive abilities under a normal s-MoCA score. The global mean s-MoCA (± SD) was 9.54 ± 3.38 points. 29.72% (N = 96) of patients had CAIDE 10 + , and 57.59% (N = 186) of patients used at-risk medication (c-ACB 3 +). We found a significant relationship between s-MoCA and CAIDE/c-ACB, respectively ( P < 0.001; R = − 0.2013; and P < 0.0001; R = − 0.3961). Conclusions Cognitive screening in community pharmacies can help identify patients with MCI. In addition, evaluation of CAIDE and at-risk medication use can improve advanced pharmaceutical care for patients with a high risk of CI.