Evidence map›Paper›PMID 23475596›Full record

ArticleDrugs & aging2013

Anticholinergic drug use, serum anticholinergic activity, and adverse drug events among older people: a population-based study.

Pasi Lampela, Piia Lavikainen, J Arturo Garcia-Horsman, J Simon Bell, Risto Huupponen, Sirpa Hartikainen

Abstract read
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In one paragraph

Article in Drugs & aging, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 11 pooled it
5.3field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

42 citing papers in PubMed, 11 syntheses or guidelines pooled it, 94 citations in OpenAlex.

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  12. Anticholinergic Exposure During Rehabilitation: Cognitive and Physical Function Outcomes in Patients with Delirium Superimposed on Dementia.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2015
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  14. Anticholinergic load and quality of life in Australian residential aged care: a retrospective cohort study.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2026
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  16. Carers' experiences and perspectives of the use of anticholinergic medications in people living with dementia: Analysis of an online discussion forum.Health expectations : an international journal of public participation in health care and health policy · 2024
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  20. Fluconazole-induced delirium in an older patient with schizophrenia.Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 2 countries.

Pasi LampelaKuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, 70211 Kuopio, Finland. Pasi.Lampela@uef.fi
Piia Lavikainen
J Arturo Garcia-Horsman
J Simon Bell
Risto Huupponen
Sirpa Hartikainen
University of Eastern Finland · FIFinland University · FIUniversity of Helsinki · FIUniversity of Turku · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe serum anticholinergic activity (SAA) assay has been used to quantify patients' anticholinergic load. In addition, several ranked lists of anticholinergic drugs have been developed to assess anticholinergic drug burden.

objectiveThis study investigated whether SAA assay results and scores from three ranked lists of anticholinergic drugs (Carnahan's Anticholinergic Drug Scale, Rudolph's Anticholinergic Risk Scale, and Chew's list) are associated with anticholinergic adverse drug events (ADEs) in older people.

methodsWe analyzed data from participants in the population-based Geriatric Multidisciplinary Good Care of the Elderly Study in Kuopio, Finland (n = 621). Demographic, diagnostic, and drug use data were collected during standardized interviews and verified from medical records. Vision, functional capacity, cognition, and mood were assessed using validated techniques. The SAA was measured from blood samples.

resultsThe SAA was not associated with anticholinergic ADEs. Anticholinergic drug burden computed using each of the three lists was inversely associated with short-distance vision (p < 0.01), activities of daily living (p < 0.05), and instrumental activities of daily living (p < 0.05) in persons with and without dementia. Furthermore, poorer Mini Mental State Examination and poorer Geriatric Depression Scale scores were associated with the anticholinergic drug burden in persons without dementia (p < 0.05-p < 0.001). The association between anticholinergic drug burden and ADEs was strongest when using the lists developed by Carnahan and Chew.

conclusionsScores obtained from ranked lists of anticholinergic drugs were associated with clinically significant anticholinergic ADEs but the SAA was not. This finding supports the usefulness of these lists to help identify patients at risk of anticholinergic ADEs in clinical practice.

Indexed as

Activities of Daily LivingAgedAged, 80 and overAnimalsCerebral CortexCholinergic AntagonistsDepressionFemaleFinlandGeriatric AssessmentHumansMaleMental Status SchedulePulmonary Disease, Chronic ObstructiveRatsRats, WistarCholinergic Antagonists

Identifiers

PMID23475596
OpenAlexW1968993693

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.