ArticleInternational journal of epidemiology2018
Baseline anticholinergic burden from medications predicts incident fatal and non-fatal stroke in the EPIC-Norfolk general population.
Article in International journal of epidemiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Quality of anticholinergic burden scales and their impact on clinical outcomes: a systematic review.European journal of clinical pharmacology · 2021Pooled it
- Association between anticholinergic drug burden and mortality in older people: a systematic review.European journal of clinical pharmacology · 2020Pooled it
- Long-Term Cardiovascular Risks of Anticholinergic Versus Non-Anticholinergic Antidepressants: A Target Trial Emulation With Negative Control Correction.Pharmacoepidemiology and drug safety · 2026Article
- Anticholinergic drug burden and incident cardiovascular events: a population-based study.BMC medicine · 2026Article
- Anticholinergic burden and incident dementia: a Swedish nationwide case-control study.Alzheimer's research & therapy · 2025Article
- Anticholinergic Burden and Its Association with Hospitalisation Risk and Causes of Admission in Older Adults with Mild Cognitive Impairment or Dementia.Clinical interventions in aging · 2025Article
- Selecting a Brief Cognitive Screening Test Based on Patient Profile: It Is Never Too Early to Start.Journal of clinical medicine · 2024Article
- Association between recently raised anticholinergic burden and risk of acute cardiovascular events: nationwide case-case-time-control study.BMJ (Clinical research ed.) · 2023Article
- Higher anticholinergic burden from medications is associated with significant increase in markers of inflammation in the EPIC-Norfolk prospective population-based cohort study.British journal of clinical pharmacology · 2022Article
- High anticholinergic burden at admission associated with in-hospital mortality in older patients: A comparison of 19 different anticholinergic burden scales.Basic & clinical pharmacology & toxicology · 2022Article
- A Cohort Study of Anticholinergic Medication Burden and Incident Dementia and Stroke in Older Adults.Journal of general internal medicine · 2021Article
- Staff Awareness of Anti-Cholinergic Burden (ACB) - A Qualitative Cross-Sectional Study in a Tertiary Care Hospital.Cureus · 2021Article
- Anticholinergic burden in older adult inpatients: patterns from admission to discharge and associations with hospital outcomes.Therapeutic advances in drug safety · 2021Article
- Anticholinergic medication exposure predicts poor physical capability: Findings from a large prospective cohort study in England.Maturitas · 2020Article
- Baseline Chronic Comorbidity and Mortality in Laboratory-Confirmed COVID-19 Cases: Results from the PRECOVID Study in Spain.International journal of environmental research and public health · 2020Article
- An overview of prevalence, determinants and health outcomes of polypharmacy.Therapeutic advances in drug safety · 2020Review
- Anticholinergic burden in middle-aged women and recurrent falls in later life: findings from the Aberdeen prospective osteoporosis screening study (APOSS).Therapeutic advances in drug safety · 2020Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
Background: Stroke is primarily a disease of older age, with a substantial impact on global mortality and morbidity. Medications with anticholinergic effects are widely used, but no studies have been conducted to examine the relationship between anticholinergic burden (ACB) and stroke in a general population. Method: The sample was drawn from the EPIC-Norfolk cohort. Baseline assessments were carried out during 1993-97 and participants were followed up until March 2016. Participants were divided into four groups according to their total ACB score at baseline; these groups were those with a total ACB score of 0, 1, 2-3 and >3. After exclusion, Cox proportional hazards models were constructed to determine the associations between the ACB score groups and the risk of incident stroke and stroke mortality. Sensitivity analysis and propensity score matched analyses were performed. Results: In total 25 639 participants attended the first health check; 3917 participants were excluded, leaving 21 722 participants to be included. Participants had a mean age [standard deviation (SD)] of 58.9 (9.2) years (54.4% women). Of these, 2131 suffered incident stroke and 562 died from stroke. Mean follow-up was approximately 18 years for both outcomes. In the fully adjusted model, those with an ACB of >3 had 59% relative risk of incident stroke {hazard ratio [HR] [95% confidence interval (CI) 1.59 [1.34-1.89]} and 86% relative risk of stroke mortality [1.86 (1.37-2.53)] compared with those in ACB 0 category. Sensitivity analyses and propensity score matched analyses showed similar results. Conclusions: Our results provide an incentive for the cautious use of medications with anticholinergic properties, to help reduce the global burden of stroke.
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