Context

Older people are particularly vulnerable to adverse cognitive effects and risk of dementia following exposure to medicines with anticholinergic activity;1 however, the biological basis for these effects remains unclear.2 The risk of anticholinergic adverse effects increases with age, polypharmacy, comorbidities, pre-existing cognitive impairment, cholinergic neuronal degeneration and changes in pharmacokinetic and pharmacodynamic properties. This study examined whether medicines with anticholinergic activity alter brain glucose metabolism, and the impact this has on brain structure, function and cognitive decline.