SynthesisBMC geriatrics2023
Development of the Swedish anticholinergic burden scale (Swe-ABS).
Synthesis in BMC geriatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03208569 (Treatment Optimization Regarding Anticholinergic Medications Potential Impact on Cognitive Test Performance), which is not on this map. Cited by 8 papers, 2 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.
Treatment Optimization Regarding Anticholinergic Medications Potential Impact on Cognitive Test Performance
Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Anticholinergic Medication Burden Scales: A Systematic Review.Journal of the American Geriatrics Society · 2026Pooled it
- Development of the Japanese Anticholinergic Risk Scale: English translation of the Japanese article.Geriatrics & gerontology international · 2025Pooled it
- Unveiling the Limits of Anticholinergic Burden Scales: A Study of Adverse Drug Reactions in the French Pharmacovigilance Database.Drug safety · 2026Article
- Utility of the Swedish Anticholinergic Burden Scale in a memory clinic setting: a comparison with the Anticholinergic Cognitive Burden scale.Scientific reports · 2026Observational
- Anticholinergic burden and incident dementia: a Swedish nationwide case-control study.Alzheimer's research & therapy · 2025Article
- Comparison of Anticholinergic Burden Scales and Their Association with Cognitive and Functional Impairment in Older Adults: A Cross-Sectional Study Using the REPOSI Database.Drugs & aging · 2025Article
- Anticholinergic burden and behavioral and psychological symptoms in older patients with cognitive impairment.Frontiers in medicine · 2025Article
- Anticholinergic burden and frailty in older inpatients: insights from analysis of admission and discharge medicines using four anticholinergic scales.BMC geriatrics · 2024Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDrugs with anticholinergic properties are associated with cognitive adverse effects, especially in patients vulnerable to central muscarinic antagonism. A variety of drugs show weak, moderate or strong anticholinergic effects. Therefore, the cumulative anticholinergic burden should be considered in patients with cognitive impairment. This study aimed to develop a Swedish Anticholinergic Burden Scale (Swe-ABS) to be used in health care and research.
methodsA systematic literature review was conducted in PubMed and Ovid Embase to identify previously published tools quantifying anticholinergic drug burden (i.e., exposure). Drugs and grading scores (0-3, no to high anticholinergic activity) were extracted from identified lists. Enteral and parenteral drugs authorized in Sweden were included. Drugs with conflicting scores in the existing lists were assessed by an expert group. Two drugs that were not previously assessed were also added to the evaluation process.
resultsThe systematic literature search identified the following nine anticholinergic burden scales: Anticholinergic Activity Scale, Anticholinergic Burden Classification, updated Anticholinergic Cognitive Burden scale, Anticholinergic Drug Scale, Anticholinergic Load Scale, Anticholinergic Risk Scale, updated Clinician-rated Anticholinergic Scale, German Anticholinergic Burden Scale and Korean Anticholinergic Burden Scale. A list of drugs with significant anticholinergic effects provided by The Swedish National Board of Health and Welfare was included in the process. The suggested Swe-ABS consists of 104 drugs scored as having weak, moderate or strong anticholinergic effects. Two hundred and fifty-six drugs were listed as having no anticholinergic effects based on evaluation in previous scales. In total, 62 drugs were assessed by the expert group.
conclusionsSwe-ABS is a simplified method to quantify the anticholinergic burden and is easy to use in clinical practice. Publication of this scale might make clinicians more aware of drugs with anticholinergic properties and patients' total anticholinergic burden. Further research is needed to validate the Swe-ABS and evaluate anticholinergic exposure versus clinically significant outcomes.
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