SynthesisEuropean journal of clinical pharmacology2021
Quality of anticholinergic burden scales and their impact on clinical outcomes: a systematic review.
Synthesis in European journal of clinical pharmacology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 5 of them syntheses 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
76 citing papers in PubMed, 5 syntheses or guidelines pooled it, 114 citations in OpenAlex.
- Concurrent Use of Anticholinergic and Antidementia Medicines in Older Adults with Dementia: A Systematic Review of Prevalence, Predictors and Clinical Outcomes.Medical sciences (Basel, Switzerland) · 2026Pooled it
- Anticholinergic Medication Burden Scales: A Systematic Review.Journal of the American Geriatrics Society · 2026Pooled it
- Differences of anticholinergic drug burden between older hospitalized patients with and without delirium: a systematic review and meta-analysis based on prospective cohort studies.BMC geriatrics · 2024Pooled it
- Development of the Swedish anticholinergic burden scale (Swe-ABS).BMC geriatrics · 2023Pooled 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
- Appropriateness over Numbers: Pharmacological Burden and Scalable Medication Review in Older Adults.Geriatrics (Basel, Switzerland) · 2026Review
- Knowing When to Stop: Navigating Polypharmacy Training in Geriatric Psychiatry.Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry · 2026Article
- Adverse outcomes between VMAT2 and anticholinergics in tardive dyskinesia: A target trial emulation.Psychiatry and clinical neurosciences · 2026Article
- How do falls-risk increasing drugs modify the association between index falls and future falls and fracture burden? Secondary data analysis from the Irish longitudinal study on ageing.European geriatric medicine · 2026Article
- Anticholinergic Burden and Progression to Kidney Replacement Therapy.Kidney international reports · 2026Article
- The effect of a complex intervention for older adults on medication adequacy: results from the + AGIL Barcelona program.BMC geriatrics · 2026Article
- Polypharmacy and anticholinergic burden are common but not independently associated with outcomes after emergency laparotomy in older adults.Langenbeck's archives of surgery · 2026Observational
- Anticholinergic Burden in Elderly People in Nursing Homes: Cross-Sectional Assessment Using ACB Calculator and CRIDECO Anticholinergic Load Scale.Medicines (Basel, Switzerland) · 2026Article
- Association Between Anticholinergic Burden and Dry Mouth Severity in Acutely Ill Older Adults.Drugs & aging · 2026Article
- The Use of Direct Oral Anticoagulants (DOACs) in Older Adults Receiving Multidose Drug Dispensing; Interactions, Anticholinergic and Fall-Risk Increasing Drugs.Geriatrics (Basel, Switzerland) · 2026Article
- Anticholinergic drug burden and incident cardiovascular events: a population-based study.BMC medicine · 2026Article
- Factors influencing the anticholinergic burden of medical prescriptions for older patients hospitalized for delirium.BMC geriatrics · 2026Article
- Evaluation of Beers Criteria Implementation in the Community Pharmacy Setting to Optimize Medication Management for Older Adults-A Pilot Study.Geriatrics (Basel, Switzerland) · 2026Article
- Neuropsychiatric symptoms and gait/balance are predictors of functional trajectories in dementias.Dementia & neuropsychologia · 2026Article
- Effect of Anticholinergic Drug Burden on Postoperative Delirium in Elderly Patients: A Nested Case-Control Study.CNS neuroscience & therapeutics · 2026Article
16 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
purposeOlder people are at risk of anticholinergic side effects due to changes affecting drug elimination and higher sensitivity to drug's side effects. Anticholinergic burden scales (ABS) were developed to quantify the anticholinergic drug burden (ADB). We aim to identify all published ABS, to compare them systematically and to evaluate their associations with clinical outcomes.
methodsWe conducted a literature search in MEDLINE and EMBASE to identify all published ABS and a Web of Science citation (WoS) analysis to track validation studies implying clinical outcomes. Quality of the ABS was assessed using an adapted AGREE II tool. For the validation studies, we used the Newcastle-Ottawa Scale and the Cochrane tool Rob2.0. The validation studies were categorized into six evidence levels based on the propositions of the Oxford Center for Evidence-Based Medicine with respect to their quality. At least two researchers independently performed screening and quality assessments.
resultsOut of 1297 records, we identified 19 ABS and 104 validations studies. Despite differences in quality, all ABS were recommended for use. The anticholinergic cognitive burden (ACB) scale and the German anticholinergic burden scale (GABS) achieved the highest percentage in quality. Most ABS are validated, yet validation studies for newer scales are lacking. Only two studies compared eight ABS simultaneously. The four most investigated clinical outcomes delirium, cognition, mortality and falls showed contradicting results.
conclusionThere is need for good quality validation studies comparing multiple scales to define the best scale and to conduct a meta-analysis for the assessment of their clinical impact.
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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.