Observational studyBMJ open2021
Anticholinergic drug burden according to the anticholinergic drug scale and the German anticholinergic burden and their impact on cognitive function in multimorbid elderly German people: a multicentre observational study.
Observational study in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Development of the Swedish anticholinergic burden scale (Swe-ABS).BMC geriatrics · 2023Pooled it
- Multimorbidity, Polypharmacy, and Neighborhood Disadvantage as Determinants of Cognitive Performance in the ARCHES Cohort.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026Article
- Anticholinergic Burden in Elderly People in Nursing Homes: Cross-Sectional Assessment Using ACB Calculator and CRIDECO Anticholinergic Load Scale.Medicines (Basel, Switzerland) · 2026Article
- Article
- Utility of the Swedish Anticholinergic Burden Scale in a memory clinic setting: a comparison with the Anticholinergic Cognitive Burden scale.Scientific reports · 2026Observational
- 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
- Anticholinergic medicines - medication management, prescribing cascades, and deprescribing.International journal of clinical pharmacy · 2025Article
- Observational
- Anticholinergic burden and clinical outcomes among older adults admitted in a tertiary hospital: a prospective cohort study.PloS one · 2025Article
- Anticholinergic burden and behavioral and psychological symptoms in older patients with cognitive impairment.Frontiers in medicine · 2025Article
- Impact of the Anticholinergic Burden on Disease-Specific Symptoms in Parkinsonian Syndromes.Brain sciences · 2024Article
- Disentangling drug contributions: anticholinergic burden in older adults linked to individual medications: a cross-sectional population-based study.BMC geriatrics · 2024Article
- Pharmaceutical Treatment of People with Dementia during the SARS-CoV-2 Pandemic in Germany: Polypharmacy, Anticholinergic Medication, and Antidementia Medication.Dementia and geriatric cognitive disorders extraArticle
Corrections and comments
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Authors and funding
16 authors at 10 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe aims of our study were to examine the anticholinergic drug use and to assess the association between anticholinergic burden and cognitive function in the multimorbid elderly patients of the MultiCare cohort.
settingMultiCare was conducted as a longitudinal cohort study in primary care, located in eight different study centres in Germany.
participants3189 patients (59.3% female). PRIMARY AND SECONDARY OUTCOME MEASURES: Baseline data were used for the following analyses. Drugs were classified according to the well-established anticholinergic drug scale (ADS) and the recently published German anticholinergic burden (German ACB). Cognitive function was measured using a letter digit substitution test (LDST) and a mixed-effect multivariate linear regression was performed to calculate the influence of anticholinergic burden on the cognitive function.
resultsPatients used 1764 anticholinergic drugs according to ADS and 2750 anticholinergics according to the German ACB score (prevalence 38.4% and 53.7%, respectively). The mean ADS score was 0.8 (±1.3), and the mean German ACB score was 1.2 (±1.6) per patient. The most common ADS anticholinergic was furosemide (5.8%) and the most common ACB anticholinergic was metformin (13.7%). The majority of the identified anticholinergics were drugs with low anticholinergic potential: 80.2% (ADS) and 73.4% (ACB), respectively. An increasing ADS and German ACB score was associated with reduced cognitive function according to the LDST (-0.26; p=0.008 and -0.24; p=0.003, respectively).
conclusionMultimorbid elderly patients are in a high risk for using anticholinergic drugs according to ADS and German ACB score. We especially need to gain greater awareness for the contribution of drugs with low anticholinergic potential from the cardiovascular system. As anticholinergic drug use is associated with reduced cognitive function in multimorbid elderly patients, the importance of rational prescribing and also deprescribing needs to be further evaluated. TRIAL REGISTRATION NUMBER: ISRCTN89818205.
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