Anticholinergic risk: Use and limitations of anticholinergic scales

Published:September 10, 2015DOI:
      The side effects of anticholinergic drugs are well known. Peripheral adverse effects are, amongst others: dry mouth, dry eyes, blurred vision, constipation, fecal impaction, urinary retention and increased heart rate. Central adverse effects are: cognitive impairment, dizziness, confusion, and, even delirium.
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        • Fundació Institut Català de Farmacologia
        Riesgos de los fármacos anticolinérgicos en personas de edad avanzada.
        ([Internet]) Fundació Institut Català de Farmacologia, Barcelona2015 ([consultado 06.07.2015. URL:])
        • Tune L.E.
        Anticholinergic effects of medication in elderly patients.
        J Clin Psychiatry. 2001; 62: 11-14
        • Durán C.E.
        • Azermai M.
        • Vander Stichele R.H.
        Systematic review of anticholinergic risk scales in older adults.
        Eur J Clin Pharmacol. 2013; 69: 1485-1496
        • Hilmer S.N.
        • Mager D.E.
        • Simonsick E.M.
        • Cao Y.
        • Ling S.M.
        • Windham B.G.
        • et al.
        A Drug Burden Index to define the functional burden of medications in older people.
        Arch Intern Med. 2007; 167: 781-787
        • Naja M.
        • Zmudka J.
        • Hannat S.
        • Liabeuf S.
        • Serot J.M.
        • Jouanny P.
        In geriatric patients, delirium symptoms are related to the anticholinergic burden.
        Geriatr Gerontol Int. 2015; ([in press])
        • Kalisch Ellett L.M.
        • Pratt N.L.
        • Ramsay E.N.
        • Barratt J.D.
        • Roughead E.E.
        Multiple anticholinergic medication use and risk of hospital admission for confusion or dementia.
        J Am Geriatr Soc. 2014; 62: 1916-1922
        • Ruxton K.
        • Woodman R.J.
        • Mangoni A.A.
        Drugs with anticholinergic effects and cognitive impairment, falls and all-cause mortality in older adults: A systematic review and meta-analysis.
        Br J Clin Pharmacol. 2015; 80: 209-220
        • Fox C.
        • Richardson K.
        • Maidment I.D.
        • Savva G.M.
        • Matthews F.E.
        • Smithard D.
        • et al.
        Anticholinergic medication use and cognitive impairment in the older population: the medical research council cognitive function and ageing study.
        J Am Geriatr Soc. 2011; 59: 1477-1483
        • Kersten H.
        • Molden E.
        • Tolo I.K.
        • Skovlund E.
        • Engedal K.
        • Wyller T.B.
        Cognitive effects of reducing anticholinergic drug burden in a frail elderly population: a randomized controlled trial.
        J Gerontol A Biol Sci Med Sci. 2013; 68: 271-278