ArticleDrugs & aging2018
Association of Anticholinergic Drug Burden with Cognitive and Functional Decline Over Time in Older Inpatients: Results from the CRIME Project.
Article in Drugs & aging, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.
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Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Quantifying Anticholinergic Burden and Sedative Load in Older Adults with Polypharmacy: A Systematic Review of Risk Scales and Models.Drugs & aging · 2021Pooled it
- Anticholinergic burden (prognostic factor) for prediction of dementia or cognitive decline in older adults with no known cognitive syndrome.The Cochrane database of systematic reviews · 2021Pooled it
- Quality of anticholinergic burden scales and their impact on clinical outcomes: a systematic review.European journal of clinical pharmacology · 2021Pooled it
- Hand Grip Strength May Affect the Association Between Anticholinergic Burden and Mortality Among Older Patients Discharged from Hospital.Drugs & aging · 2020Trial
- Efficacy of novel βInternational journal of urology : official journal of the Japanese Urological Association · 2019Trial
- Cognitive function in the context of pharmacogenetic CYP2D6 variability and anticholinergic burden in older adults - results from the ActiFE study.European journal of clinical pharmacology · 2026Article
- Associations of anticholinergic burden of medication with cognitive decline and longitudinal brain atrophy in the Alzheimer's disease spectrum.Frontiers in aging neuroscience · 2026Article
- Anticholinergic burden in community-dwelling older adults: prevalence, associated factors, and agreement between measurement scales.Frontiers in pharmacology · 2026Article
- Ten-Year Outcomes of Anticholinergic Use Among Older Adults With Intellectual Disability: Findings From the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA).Journal of intellectual disability research : JIDR · 2025Article
- CALS and ACB Scales are Associated with Physical and Cognitive Impairment and Predict Mortality in Nursing Home Residents.Drugs - real world outcomes · 2025Article
- [Study of anticholinergic burden in chronic treatments of outpatients in the Community Pharmacy].Farmaceuticos comunitarios · 2025Observational
- The anticholinergic burden in patients with chronic kidney disease: Patterns, risk factors, and the link with cognitive impairment.Journal of the American Geriatrics Society · 2025Article
- Impact of the Anticholinergic Burden on Disease-Specific Symptoms in Parkinsonian Syndromes.Brain sciences · 2024Article
- Drug prescriptions in elderly hospitalized patients with cognitive impairment in the Italian Dementia Friendly Hospital project.Frontiers in pharmacology · 2024Article
- Anticholinergic Burden and Cognitive Impairment in Nursing Homes: A Comparison of Four Anticholinergic Scales.Drugs & aging · 2023Article
- Anticholinergic burden and cognitive performance: cross-sectional results from the ELSA-Brasil study.European journal of clinical pharmacology · 2022Article
- The Predictive Value of Anticholinergic Burden Measures in Relation to Cognitive Impairment in Older Chronic Complex Patients.Journal of clinical medicine · 2022Article
- Anticholinergic medication burden and cognitive function in participants of the ASPREE study.Pharmacotherapy · 2022Article
- The adverse effects of long-term exposure to anticholinergics among people with intellectual disabilities: a scoping review.HRB open research · 2022Article
- The Interplay between Anticholinergic Burden and Anemia in Relation to 1-Year Mortality among Older Patients Discharged from Acute Care Hospitals.Journal of clinical medicine · 2021Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundMedications with anticholinergic properties, although widely used, may negatively affect cognitive and functional status in older patients. To date there is still no standardized method to quantify anticholinergic exposure. We analyzed the relationship of two different tools for the evaluation of the anticholinergic drug burden with cognitive and functional impairment in a sample of older hospitalized patients.
methodsA retrospective and longitudinal analysis with 1-year follow-up of 1123 older hospitalized patients enrolled in seven Italian acute care wards was conducted. We assessed anticholinergic burden with the Anticholinergic Cognitive Burden (ACB) and Anticholinergic Risk Scale (ARS). Cognitive and functional status were evaluated at hospital discharge and during follow-up (3, 6, 12 months) using the Mini Mental State Examination (MMSE) and five basic activities of daily living (ADLs). Associations between anticholinergic burden and cognitive decline and incident disability were estimated using linear regression models for repeated measures and logistic models, respectively.
resultsThe mean age of the study population was 81 ± 7.5 years. ACB and ARS classifications showed low correlation (Spearman's rho = 0.39-0.43). Anticholinergic burden increased during hospitalization and was associated with cognitive and functional status. Patients with an ARS of ≥ 1 at discharge had significantly lower baseline MMSE scores (ARS = 0: 23.1; ARS ≥ 1: 20.8; p = 0.002) and during follow-up presented a significantly steeper MMSE score decline (- 0.15/month). Moreover, patients with an ACB of ≥ 1 at discharge had an almost threefold increased risk of developing disability (odds ratio 2.77, 95% confidence interval 1.39-5.54).
conclusionsACB and ARS have only a moderate degree of correlation. Use of drugs with anticholinergic properties in elderly patients is independently associated with cognitive and functional decline.
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