SynthesisDrugs & aging2021
Quantifying Anticholinergic Burden and Sedative Load in Older Adults with Polypharmacy: A Systematic Review of Risk Scales and Models.
Synthesis in Drugs & aging, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.
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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
26 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Anticholinergic Medication Burden Scales: A Systematic Review.Journal of the American Geriatrics Society · 2026Pooled it
- Prevalence and factors associated with anticholinergic medication use in community-dwelling older adults: a systematic review.International journal of clinical pharmacy · 2025Pooled it
- Development of the Swedish anticholinergic burden scale (Swe-ABS).BMC geriatrics · 2023Pooled it
- Japanese Anticholinergic Risk Scale and Domain-Specific Functional Outcomes in Older Poststroke Patients.Geriatrics & gerontology international · 2026Article
- Drug Utilisation of Fall-Risk-Increasing Drugs (FRIDs) and Risk of Hospitalisation: A Nested Case-Control Study Among Community-Dwelling Older Adults.Drugs & aging · 2026Article
- Physicians' awareness of non-pharmacological therapies for insomnia in the Czech Republic.Croatian medical journal · 2026Article
- PsychoPharm aggregated risk score (PARS): a multidimensional tool to flag high-risk pharmacotherapy in psychiatric patients.Frontiers in pharmacology · 2026Article
- Household Wealth and Potentially Inappropriate Medications in Persons With Dementia: Role of Comorbidities and Caregivers.Journal of the American Geriatrics Society · 2025Article
- Article
- Examining objective and subjective sleep measures and neurocognition in older adults with HIV: A cross-sectional study in the deep South.Applied neuropsychology. Adult · 2024Article
- Anticholinergic burden and frailty in older inpatients: insights from analysis of admission and discharge medicines using four anticholinergic scales.BMC geriatrics · 2024Article
- Impact of Hospitalizations on Problematic Medication Use Among Community-Dwelling Persons With Dementia.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Article
- Medication burden and anticholinergic use are associated with overt HE in individuals with cirrhosis.Hepatology communications · 2024Article
- Long-term clinical course of adult-onset refractory epilepsy in cardiofaciocutaneous syndrome with a pathogenicFrontiers in genetics · 2024Article
- Comparative analysis of anticholinergic burden scales to explain iatrogenic cognitive impairment in schizophrenia: results from the multicenter FACE-SZ cohort.Frontiers in pharmacology · 2024Article
- Medication misuse and overuse in community-dwelling persons with dementia.Journal of the American Geriatrics Society · 2023Article
- Association between recently raised anticholinergic burden and risk of acute cardiovascular events: nationwide case-case-time-control study.BMJ (Clinical research ed.) · 2023Article
- Anticholinergic burden in middle and older age is associated with lower cognitive function, but not with brain atrophy.British journal of clinical pharmacology · 2023Article
- Evaluation of the Effect of Barberry Root (Berberis Vulgaris) on the Prevention of Metabolic Syndrome Caused by Atypical Antipsychotic Drugs in Patients with Schizophrenia: A Three-Blind Placebo-Controlled Clinical Trial.Iranian journal of psychiatry · 2023Article
- Development of a pharmacological evidence-based anticholinergic burden scale for medications commonly used in older adults.Geriatrics & gerontology international · 2023Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients taking medication with high anticholinergic and sedative properties are at increased risk of experiencing poor cognitive and physical outcomes. Therefore, precise quantification of the cumulative burden of their drug regimen is advisable. There is no agreement regarding which scale to use to simultaneously quantify the burden associated with medications.
objectivesThe objective of this review was to assess the strengths and limitations of available tools to quantify medication-related anticholinergic burden and sedative load in older adults. We discuss specific limitations and agreements between currently available scales and models and propose a comprehensive table combining drugs categorized as high, moderate, low, or no anticholinergic or sedative activity as excerpted from the selected studies.
methodsA targeted search was carried out using the National Library of Medicine through PubMed using medical subject heading terms and text words around the following search terms: (anticholinergic OR sedative) AND (load OR burden OR scale) for studies published between 1 January 1945 and 5 June 2021. In addition, the following databases were searched using the same terms: MEDLINE-EBSCO, APA PsycInfo, CINAHL Plus, Cochrane Library, Scopus, OAIster, OVID-MEDLINE, Web of Science, and Google Scholar. Screening by titles was followed by an abstract and full-text review. After blind evaluation, agreement between reviewers was reached to establish drug characteristics and categories.
resultsAfter 3163 articles were identified, 13 were included: 11 assigned risk scores to anticholinergic drugs and two to sedative drugs. Considerable variability between anticholinergic scales was observed; scales included between 27 and 548 drugs. We generated a comprehensive table combining the anticholinergic and sedative activities of drugs evaluated and proposed a categorization of these drugs based on available scientific and clinical evidence. Our table combines information about 642 drugs and categorizes 44, 25, 99, and 474 drugs as high, moderate, low, or no anticholinergic and sedative activity, respectively.
conclusionsVariability and inconsistency exists among scales used to categorize drugs with anticholinergic or sedative burden. In this review, we provide a comprehensive table that proposes a new categorization of these drugs. A longitudinal study will be required to validate the new proposed anticholinergic and sedative burden catalog in an evidence-based manner.
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