SynthesisDrugs - real world outcomes2021
Associations Between Anticholinergic Medication Exposure and Adverse Health Outcomes in Older People with Frailty: A Systematic Review and Meta-analysis.
Synthesis in Drugs - real world outcomes, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 4 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Deprescribing Anticholinergic Medications in Hospitalised Older Adults: A Systematic Review.Basic & clinical pharmacology & toxicology · 2025Pooled it
- Effectiveness of non-pharmacological interventions delivered at home for urinary and faecal incontinence with homebound older people: systematic review of randomised controlled trials.Age and ageing · 2024Pooled it
- The association between anticholinergic burden and mobility: a systematic review and meta-analyses.BMC geriatrics · 2023Pooled it
- Impact of frailty, mild cognitive impairment and cognitive frailty on adverse health outcomes among community-dwelling older adults: A systematic review and meta-analysis.Frontiers in medicine · 2022Pooled it
- Feasibility study of the Care-at-Home Pharmacotherapy Service (CAHPS): pharmacy technician-led home visits for people receiving polypharmacy who are housebound living in socioeconomically deprived areas.International journal of clinical pharmacy · 2026Article
- The Feasibility and Acceptability of a Collaborative Deprescribing Intervention to Reduce Anticholinergic Burden Among Hospitalised Older Patients.Basic & clinical pharmacology & toxicology · 2026Article
- A consolidated framework for implementation research (CFIR) informed exploration of a primary care intervention to support deprescribing for problematic polypharmacy in older adults living with frailty (DEPPLOY) in England: a qualitative study.International journal of clinical pharmacy · 2026Article
- Anticholinergic Burden in Elderly People in Nursing Homes: Cross-Sectional Assessment Using ACB Calculator and CRIDECO Anticholinergic Load Scale.Medicines (Basel, Switzerland) · 2026Article
- Oral health in people with schizophrenia: associations with behavioural and pharmacological factors.Epidemiology and psychiatric sciences · 2026Article
- Reducing medication burden and improving pressure injury outcomes in older emergency patients: a pharmacist-nurse collaboration.Frontiers in medicine · 2026Article
- Anticholinergic burden and its associated factors among adult outpatients in a resource-limited setting: a cross-sectional study.Scientific reports · 2025Article
- Walking through aging: A review of gait laboratory-based assessments and geriatric syndromes.The Journal of frailty & aging · 2025Review
- Evaluating the Anticholinergic Burden in Older Patients: Comprehensive Insights from a Nationwide Survey Among Emergency Medicine Specialists in the UK.Geriatrics (Basel, Switzerland) · 2025Article
- Anticholinergic and Sedative Medication Burden in Croatian Older Adults: EuroAgeism Cohort Findings.Pharmacy (Basel, Switzerland) · 2025Article
- [Frailty and pharmacotherapy].Innere Medizin (Heidelberg, Germany) · 2025Review
- Anticholinergic drug exposure is associated with prevalence, worsening and incidence of dysphagia among hospitalized older adults.The journal of nutrition, health & aging · 2025Article
- Anticholinergic burden quantified using the Japanese risk scale as a predictor of frailty and sarcopenia among community-dwelling older adults: A 9-year Kashiwa cohort study.Geriatrics & gerontology international · 2025Article
- Multimorbidity, medications, and their association with falls, physical activity, and cognitive functions in older adults: multicenter study in Sri Lanka.Scientific reports · 2025Article
- The relationship between anticholinergic drug burden and clinical frailty in urinary incontinence patients.Revista da Associacao Medica Brasileira (1992) · 2025Article
- Chronic polypharmacy, monotherapy, and deprescribing: Understanding complex effects on the hepatic proteome of aging mice.Aging cell · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
introductionThere are robust associations between use of anticholinergic medicines and adverse effects in older people. However, the nature of these associations for older people living with frailty is yet to be established.
objectivesThe aims were to identify and investigate associations between anticholinergics and adverse outcomes in older people living with frailty and to investigate whether exposure is associated with greater risks according to frailty status.
methodsMEDLINE, CINAHL, EMBASE, Cochrane Database of Systematic Reviews, Web of Science and PsycINFO were searched to 1 August 2019. Observational studies reporting associations between anticholinergics and outcomes in older adults (average age ≥ 65 years) that reported frailty using validated measures were included. Primary outcomes were physical impairment, cognitive dysfunction, and change in frailty status. Risk of bias was evaluated using the Cochrane Risk of Bias In Non-randomised Studies of Interventions (ROBINS-I) tool. Meta-analysis was undertaken where appropriate.
resultsThirteen studies (21,516 participants) were included (ten community, one residential aged-care facility and two hospital studies). Observed associations included reduced ability for chair standing, slower gait speeds, poorer physical performance, increased risk of falls and mortality. Conflicting results were reported for grip strength, timed up and go test, cognition and activities of daily living. No associations were observed for transitions between frailty states, psychological wellbeing or benzodiazepine-related adverse reactions. There was no clear evidence of differences in risks according to frailty status.
conclusionsAnticholinergics are associated with adverse outcomes in older people living with frailty; however, the literature has significant methodological limitations. There is insufficient evidence to suggest greater risks based on frailty, and there is an urgent need to evaluate this further in well-designed studies stratifying by frailty.
Identifiers
What OpenQuestion holds
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.