Evidence map›Paper›PMID 41400935›Full record

ArticleInternational journal for quality in health care : journal of the International Society for Quality in Health Care2026

Anticholinergic load and quality of life in Australian residential aged care: a retrospective cohort study.

Ying Xu, Ling Li, Nasir Wabe, Magdalena Z Raban, Guogui Huang, Amy D Nguyen, S Sandun Malpriya Silva, Rachel Urwin, Johanna I Westbrook

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Article in International journal for quality in health care : journal of the International Society for Quality in Health Care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Ying XuAustralian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia.ORCID 0000-0002-3793-7716
Ling LiAustralian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia.ORCID 0000-0002-1642-142X
Nasir WabeAustralian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia.
Magdalena Z RabanAustralian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia.
Guogui HuangAustralian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia.
Amy D NguyenAustralian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia.ORCID 0000-0003-4603-564X
S Sandun Malpriya SilvaAustralian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia.
Rachel UrwinAustralian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia.
Johanna I WestbrookAustralian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia.ORCID 0000-0003-1083-8192

Funding

Australian National Health and Medical Research Council APP1170898
6 · The paper itself

Abstract

backgroundThe specific impact of anticholinergic load on quality of life is understudied. We aimed to investigate relationships between anticholinergic load and quality of life in residential aged care facilities and differences between residents with and without dementia.

methodsWe conducted a retrospective cohort study of 21 residential aged care facilities in New South Wales, Australia. Residents aged ≥65 years for permanent care. Residents had their quality of life measured using the Quality of Life Aged Care Consumers tool in 2023 at baseline (July-September) and follow-up (October-December, the study outcome). Higher scores indicate better quality of life. Anticholinergic load of administered medications between two quality of life measures was evaluated using five existing scales: Anticholinergic Cognitive Burden, Anticholinergic Drug Scale, Anticholinergic Loading Scale, Anticholinergic Risk Scale, and Clinician-rated Anticholinergic Score. Associations between anticholinergic load from each scale and follow-up quality of life scores were examined using linear regression, controlling for age, sex, baseline quality of life scores, and other potential confounders. Interactions between anticholinergic load and dementia were tested. Analyses were conducted for overall cohort and a subgroup analysis was performed for residents with and without dementia.

resultsA total of 927 residents (69.7% female) were included. One-point higher anticholinergic load measured on each of the Anticholinergic Loading Scale, Anticholinergic Risk Scale, and Clinician-rated Anticholinergic Score, was associated with lower quality of life scores at follow-up: -0.24 (95% confidence interval -0.47, -0.01), -0.26 (95% confidence interval -0.46, -0.05), and -0.25 (95% confidence interval -0.49, -0.01), respectively. Associations did not differ by dementia status. In a subgroup analysis, the associations remained statistically significant in residents without dementia (n = 501), but not in those with dementia (n = 426).

conclusionOur results indicate that, controlling for baseline quality of life, anticholinergic load was associated with lower quality of life at follow-up over a short period (up to 6 months).

Indexed as

Cholinergic AntagonistsDementiaHomes for the AgedQuality of LifeAgedAged, 80 and overFemaleHumansMaleNew South WalesRetrospective StudiesCholinergic Antagonistsanticholinergic loadmedication usewellbeing

Identifiers

PMID41400935
PMCPMC12817077

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