ArticleDrugs & aging2020
Adverse Effects of Anticholinergic Drugs on Cognition and Mobility: Cutoff for Impairment in a Cross-Sectional Study in Young-Old and Old-Old Adults.
Article in Drugs & aging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The association between anticholinergic burden and mobility: a systematic review and meta-analyses.BMC geriatrics · 2023Pooled it
- Associations between Anticholinergic Burden and Skeletal Muscle Indices and Physical Function in Older Adults: A Scoping Review.JMA journal · 2026Review
- Association between anticholinergic and sedative medications and physical functioning: data from the Canadian longitudinal study on aging (CLSA).European journal of clinical pharmacology · 2026Article
- Association of changes in medication with the effectiveness of rehabilitation in older patients: a hospital-based observational study.BMC geriatrics · 2026Observational
- Progress in research on cognitive frailty in the older adults: a narrative review.Frontiers in medicine · 2026Review
- 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 and Sedative Medication Burden in Croatian Older Adults: EuroAgeism Cohort Findings.Pharmacy (Basel, Switzerland) · 2025Article
- Muscarinic Receptor Antagonism and TRPM3 Activation as Stimulators of Mitochondrial Function and Axonal Repair in Diabetic Sensorimotor Polyneuropathy.International journal of molecular sciences · 2025Review
- Interdisciplinary pharmaceutical care model engaging patient participation alleviate the anticholinergic burden in community-dwelling older adults: subgroup analysis of a randomized controlled trial.Therapeutic advances in drug safety · 2025Article
- Involvement of cognitive abilities in the occurrence of fractures in fallers aged 55 years or older: a cross-sectional study.Aging clinical and experimental research · 2024Article
- Clinical pharmacist-led assessment and management of anticholinergic burden and fall risk in geriatric patients.BMC geriatrics · 2023Article
- Review
- Anticholinergic burden in middle and older age is associated with lower cognitive function, but not with brain atrophy.British journal of clinical pharmacology · 2023Article
- Reducing Falls in Older Women with Urinary Incontinence.Advances in geriatric medicine and research · 2023Article
- The PAPA Questionnaire: Assessment of Long-Term Engagement in Activities, with Separate Quantification of Their Physical, Cognitive, and Social Components.Clinical interventions in aging · 2023Review
- Relationship between Vitamin C Deficiency and Cognitive Impairment in Older Hospitalised Patients: A Cross-Sectional Study.Antioxidants (Basel, Switzerland) · 2022Article
- Effects of chronic tramadol administration on cognitive flexibility in mice.Psychopharmacology · 2021Article
- The cognitive effects of anticholinergic drugs on apolipoprotein ε4 carriers and noncarriers in the Wisconsin Registry for Alzheimer's Prevention study.Neuropsychology · 2021Article
- Current pharmacotherapy of overactive bladder.International braz j urol : official journal of the Brazilian Society of UrologyReview
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundDrugs with anticholinergic properties are commonly prescribed in older adults despite growing evidence of their adverse outcomes. Several issues regarding these detrimental effects remain unresolved, such as the putative existence of a threshold above which anticholinergic drug consumption impairs cognitive or mobility performance.
objectivesWe aimed to investigate the number of anticholinergic drugs and the anticholinergic burden that leads to mobility or cognitive impairment and compare the effects in community-dwelling older adults in two age groups ("young-old" 55-74 vs. "old-old" ≥ 75 years).
methodsIn a cross-sectional study, we identified drugs with anticholinergic (antimuscarinic) properties using the Anticholinergic Drug Scale. Cognition was assessed using the Mini Mental State Examination (MMSE) and the Trail Making Test (TMT-A and TMT-B), and mobility was assessed using the Timed Up and Go (TUG) test.
resultsThe study population consisted of 177 volunteers, 114 of whom were classed as young-old and 63 were classed as old-old adults. Despite the lack of cutoff values for impaired outcomes in young-old adults, impaired MMSE were significantly more numerous in users than in nonusers of anticholinergic drugs. In old-old adults, receiver operating characteristic (ROC) curve analysis indicated that taking a single anticholinergic drug per day was associated with impaired TMT-B completion time, TMT difference score (B-A), and TUG scores. The cutoff for anticholinergic burden was also one for these same outcomes. Based on these cutoff values, multivariate logistic regressions in old-old adults showed that the increased risk of impaired cognition and mobility was independent of confounding factors, including comorbidities. They also suggested that anticholinergic drugs would affect mobility through executive functions.
conclusionsDrugs with anticholinergic (antimuscarinic) properties are associated with cognitive impairment in individuals as young as 55 years, and only one such drug per day, regardless of its anticholinergic burden, is associated with both impaired cognition and impaired mobility in old-old adults. Therefore, wherever possible, clinicians should avoid prescribing drugs with anticholinergic properties.
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Registered trials
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.