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Cited by 369Pharmaceutical Practices and Patient OutcomesPharmaceutical studies and practicesPain Management and Opioid Use

The DOI matches its Crossref record.

Systematic review of anticholinergic risk scales in older adults

Durán, Carlos E., Azermai, Majda, Vander Stichele, Robert H.·2013·European Journal of Clinical Pharmacology
DOI 10.1007/s00228-013-1499-3
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Abstract

Background Anticholinergic drugs are often involved in explicit criteria for inappropriate prescribing in older adults. Several scales were developed for screening of anticholinergic drugs and estimation of the anticholinergic burden. However, variation exists in scale development, in the selection of anticholinergic drugs, and the evaluation of their anticholinergic load. This study aims to systematically review existing anticholinergic risk scales, and to develop a uniform list of anticholinergic drugs differentiating for anticholinergic potency. Methods We performed a systematic search in MEDLINE. Studies were included if provided (1) a finite list of anticholinergic drugs; (2) a grading score of anticholinergic potency and, (3) a validation in a clinical or experimental setting. We listed anticholinergic drugs for which there was agreement in the different scales. In case of discrepancies between scores we used a reputed reference source (Martindale: The Complete Drug Reference®) to take a final decision about the anticholinergic activity of the drug. Results We included seven risk scales, and evaluated 225 different drugs. Hundred drugs were listed as having clinically relevant anticholinergic properties (47 high potency and 53 low potency), to be included in screening software for anticholinergic burden. Conclusion Considerable variation exists among anticholinergic risk scales, in terms of selection of specific drugs, as well as of grading of anticholinergic potency. O…

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  • The study also included additional drugs from the Beers 2015 updated list of strong anticholinergic drugs, the Anticholinergic Cognitive Burden scale, a systematic review, and the British National Formulary.

    “We also included additional drugs in the Beers 2015 updated list of strong anticholinergic drugs,15 drugs listed as having a high anticholinergic burden in the Anticholinergic Cognitive Burden scale,16 or identified as high-potency anticholinergics in a systematic review,17 and some further drugs identified as having substantial anticholinergic properties in the British National Formulary”

    From Anticholinergic Drug Exposure and the Risk of Dementia: A Nested Case-Control Study (2019) · cites this paper as [17]

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Research works printed but not linked: 20

  1. Tune LE (2001) Anticholinergic effects of medication in elderly patients. J Clin Psychiatry 62(suppl 21):11–14
  2. Hilmer SN, McLachlan A, Le Couteur DG (2007) Clinical pharmacology in the geriatric patient. Fundam Clin Pharmacol 21:217–320 · DOI
  3. de Leon J (2011) Paying attention to pharmacokinetic and pharmacodynamic mechanisms to progress in the area of anticholinergic use in geriatric patients. Curr Drug Metab 12(7):635–646 · DOI
  4. Shi S, Klotz U (2011) Age-related changes in pharmacokinetics. Curr Drug Metab 12(7):601–610 · DOI
  5. Remillard AJ (1996) A pharmacoepidemiological evaluation of anticholinergic prescribing patterns in the elderly. Pharmacoepidemiol Drug Saf 5:155–164 · DOI
  6. Ness J, Hoth A, Barnett MJ, Shorr RI, Kaboli PJ (2006) Anticholinergic medications in community-dwelling older veterans: prevalence of anticholinergic symptoms, symptom burden, and adverse drug events. Am J Geriatr Pharmacother 4(1):42–51 · DOI
  7. Kumpula E-K, Bell JS, Soini H, Pitkälä KH (2011) Anticholinergic drug use and mortality among residents of long-term care facilities: a prospective cohort study. J Clin Pharmacol 51(2):256–263 · DOI
  8. Gerretsen P, Pollock BG (2011) Rediscovering adverse anticholinergic effects. J Clin Psychiatry 72(6):869–870 · DOI
  9. Wilson NM, Hilmer SN, March LM, Cameron ID, Lord SR, Seibel MJ et al (2011) Associations between drug burden index and falls in older people in residential aged care. J Am Geriatr Soc 59:875–880 · DOI
  10. Fox C, Richardson K, Maidment ID, Savva GM, Matthews FE, Smithard D et al (2011) Anticholinergic medication use and cognitive impairment in the older population: The Medical Research Council Cognitive Function and Ageing Study. J Am Geriatr Soc 59:1477–1483 · DOI · Paper page
  11. Carnahan RM, Lund BC, Perry PJ, Pollock BG, Culp KR (2006) The Anticholinergic Drug Scale as a measure of drug-related anticholinergic burden: associations with serum anticholinergic activity. J Clin Pharmacol 46:1481–1486 · DOI
  12. Ancelin ML, Artero S, Portet F, Dupuy AM, Touchon J, Ritchie K (2006) Non-degenerative mild cognitive impairment in elderly people and use of anticholinergic drugs: longitudinal cohort study. BMJ 332:455–459 · DOI · Paper page
  13. Chew ML, Mulsant BH, Pollock BG, Lehman ME, Greenspan A, Mahmoud RA et al (2008) Anticholinergic activity of 107 medications commonly used by older adults. J Am Geriatr Soc 56(7):1333–1341 · DOI
  14. Rudolph JL, Salow MJ, Angelini MC, McGlinchey RE (2008) The anticholinergic risk scale and anticholinergic adverse effects in older persons. Arch Intern Med 168(5):508–513 · DOI · Paper page
  15. Han L, Agostini JV, Allore HG (2008) Cumulative Anticholinergic exposure is associated with poor memory and executive funtion in older men. J Am Geriatr Soc 56:2203–2210 · DOI
  16. Ehrt U, Broich K, Larsen JP, Ballard C, Aarsland D (2010) Use of drugs with anticholinergic effect and impact on cognition in Parkinson’s disease: a cohort study. J Neurol Neurosurg Psychiatry 81:160–165 · DOI · Paper page
  17. Sittironnarit G, Ames D, Bush AI, Faux N, Flicker L, Foster J, Hilmer S et al (2011) Effects of anticholinergic drugs on cognitive function in older Australians: results from the AIBL Study. Dement Geriatr Cogn Disord 31:173–178 · DOI
  18. Sweetman SC (ed) (2011) Martindale: The complete drug reference. [online] Pharmaceutical Press, London < http://www.medicinescomplete.com/ > (Accessed on 11–2011).
  19. Campbell N, Boustani M, Limbil T, Ott C, Fox C, Maidment I et al (2009) The cognitive impact of anticholinergics: a clinical review. Clin Interv Aging 4:225–233
  20. Kersten H, Molden E, Tolo IK, Skovlund E, Engedal K, Wyller TB (2013) Cognitive effects of reducing anticholinergic drug burden in a frail elderly population: a randomized controlled trial. J Gerontol A BiolSci Med Sci 68(3):271–278 · DOI · Paper page

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Metadata

Authors
Durán, C. E., Azermai, M., & Vander Stichele, R. H.
Affiliations
  • Central University of Ecuador (EC)
  • Ghent University (BE)
ORCID
Durán, Carlos E.
Venue
European Journal of Clinical Pharmacology
Publisher
Springer Science and Business Media LLC
Published
2013-03-26
Volume
69
Issue
7
Pages
1485-1496
ISSN
  • 0031-6970 (ISSN-L)
  • 1432-1041
DOI
10.1007/s00228-013-1499-3
OpenAlex
W2147584980
Cited by
369
References
0
Citations by year
2026: 14 · 2025: 21 · 2024: 31 · 2023: 38 · 2022: 23 · 2021: 41 · 2020: 47 · 2019: 32 · 2018: 26 · 2017: 25 · 2016: 26 · 2015: 25 · 2014: 14 · 2013: 4
FWCI
1.48
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • European Journal of Clinical Pharmacology (publishedVersion)
  • PubMed (publishedVersion)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion)
Funders
Vlaamse Interuniversitaire Raad
Topics
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
Anticholinergic Risk Scale, anticholinergic burden, anticholinergic agents, older adults, inappropriate prescribing, polypharmacy, drug screening, scale validation
MeSH terms
Aging, Pharmaceutical Preparations, Humans, Risk, Cholinergic Antagonists, Polypharmacy, Pharmacovigilance, Databases, Pharmaceutical, Drug-Related Side Effects and Adverse Reactions

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