ArticlePloS one2021
Anticholinergic burden: First comprehensive analysis using claims data shows large variation by age and sex.
Article in PloS one, 2021. 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
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
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Development of the Swedish anticholinergic burden scale (Swe-ABS).BMC geriatrics · 2023Pooled it
- Differences in Anticholinergic Exposure Assessment Across Burden Scales and Exposure Measures in a Population-Based Study: Implications for Targeted Deprescribing in Older Adults.Drugs & aging · 2026Article
- Factors influencing the anticholinergic burden of medical prescriptions for older patients hospitalized for delirium.BMC geriatrics · 2026Article
- Utility of the Swedish Anticholinergic Burden Scale in a memory clinic setting: a comparison with the Anticholinergic Cognitive Burden scale.Scientific reports · 2026Observational
- Nationwide trends in psychiatric prescription practices for drugs with putative cognitive adverse effects in schizophrenia spectrum and bipolar disorders from 2013 to 2022.Journal of pharmaceutical policy and practice · 2026Article
- Anticholinergic burden and its associated factors among adult outpatients in a resource-limited setting: a cross-sectional study.Scientific reports · 2025Article
- A simulation study comparing anticholinergic drug use with polypharmacy for risk of death, dementia, and delirium in UK Biobank.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025Article
- Anticholinergic and Sedative Medication Burden in Croatian Older Adults: EuroAgeism Cohort Findings.Pharmacy (Basel, Switzerland) · 2025Article
- The Impact of Real-world Use of Overactive Bladder Medications on Dementia Risk in Younger Adults.European urology open science · 2025Article
- Observational
- The assessment of the relationship between anticholinergic burden and short-term blood pressure variability.BMC pharmacology & toxicology · 2025Article
- Anticholinergic Burden and Dry Mouth Problems Among Older Adults (≥ 50 Years) Receiving Dental Care-A Retrospective, Cross-Sectional Analysis.Clinical and experimental dental research · 2024Article
- Association of systemic anticholinergic medication use and accelerated decrease in lung function in older adults.Scientific reports · 2024Article
- Health-related quality of life and use of medication with anticholinergic activity in patients with multiple myeloma.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Article
- A study on prescriptions contributing to the risk of high anticholinergic burden in adults with intellectual disabilities: retrospective record linkage study.Annals of general psychiatry · 2022Article
- Beauty of the beast: anticholinergic tropane alkaloids in therapeutics.Natural products and bioprospecting · 2022Review
- Cognitive dysfunction in schizophrenia: An expert group paper on the current state of the art.Schizophrenia research. Cognition · 2022Review
- A novel Artificial Intelligence-based tool to assess anticholinergic burden: a survey.Age and ageing · 2022Article
- Anticholinergic burden and polypharmacy in hospitalized urology patients: Prevalence and clinical implications.Indian journal of urology : IJU : journal of the Urological Society of IndiaArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe cumulative effect of medication inhibiting acetylcholine activity-also known as anticholinergic burden (AB)-can lead to functional and cognitive decline, falls, and death. Given that studies on the population prevalence of AB are rare, we aimed to describe it in a large and unselected population sample.
methodsUsing the German Pharmacoepidemiological Research Database (GePaRD) with claims data from ~20% of the German population we analyzed outpatient drug dispensations in 2016. Based on the Anticholinergic Cognitive Burden (ACB) scale, we classified persons into four categories and determined the cumulative AB as continuous variable.
resultsAmong 16,470,946 persons (54% female), the prevalence of clinically relevant AB (ACB≥3) was 10% (women) and 7% (men). Below age 40 it was highest in persons ≤18 years (6% both sexes). At older ages (50-59 vs. 90-99 years), prevalence of ACB≥3 increased from 7% to 26% (men) and from 10% to 32% (women). Medication classes contributing to the cumulative AB differed by age: antihistamines, antibiotics, glucocorticoids (≤19 years), antidepressants (20-49 years), antidepressants, cardiovascular medication, antidiabetics (50-64 years), and additionally medication for urinary incontinence/overactive bladder (≥65 years). Medication dispensed by general physicians contributed most to the cumulative AB.
conclusionAlthough a clinically relevant AB is particularly common in older persons, prevalence in younger age groups was up to 7%. Given the risks associated with AB in older persons, targeted interventions at the prescriber level are needed. Furthermore, risks associated with AB in younger persons should be explored.
Indexed as
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.