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Related Experiment Video

Updated: Feb 23, 2026

A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development

A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development

Published on: February 11, 2019

Reduction of the Anticholinergic Burden Makes It Possible to Decrease Behavioral and Psychological Symptoms of

Yacine Jaïdi¹, Vignon Nonnonhou², Lukshe Kanagaratnam³

¹Departments of Geriatrics and Internal Medicine, Reims University Hospitals, Maison Blanche Hospital, Reims, France; Faculty of MedicineEA 3797, University of Reims Champagne-Ardenne, Reims, France.

The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry

|September 12, 2017

Summary

Reducing anticholinergic burden (AB) in dementia patients significantly lowers behavioral and psychological symptoms of dementia (BPSD) and lessens caregiver burden. Prioritizing non-pharmacological approaches is recommended for managing dementia care.

Keywords:

Behavioral disorders cholinergic antagonist cognitive disorders dementia drug effects

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Published on: January 24, 2020

Area of Science:

Geriatric Medicine
Neurology
Pharmacology

Background:

Anticholinergic medications are frequently prescribed to elderly individuals.
These drugs can exacerbate behavioral and psychological symptoms of dementia (BPSD) and increase caregiver burden.
Reducing the anticholinergic burden (AB) is a potential strategy to mitigate these adverse effects.

Purpose of the Study:

To assess the impact of reducing the anticholinergic burden (AB) on the frequency and severity of BPSD.
To evaluate the effect of AB reduction on occupational disruptiveness experienced by the care team.
To determine the efficacy of AB reduction in managing dementia-related symptoms.

Main Methods:

A prospective, single-center study involving 125 elderly dementia patients with BPSD.
Anticholinergic Cognitive Burden Scale used to quantify AB reduction.
Neuropsychiatric Inventory-Nursing Home Version (NPI-NH) employed to assess BPSD.
Logistic regression analysis adjusted for comprehensive geriatric assessment variables.

Main Results:

A reduction in AB by at least 20% led to a significant decrease in NPI-NH frequency × severity scores (aOR: 3.5; 95% CI: 1.6-7.9).
Occupational disruptiveness scores also significantly decreased with AB reduction (aOR: 9.9; 95% CI: 3.6-27.3).
The study included diverse dementia types, with 56.8% having probable Alzheimer disease.

Conclusions:

Reducing the anticholinergic burden in elderly dementia patients effectively decreases BPSD and caregiver burden.
Minimizing the use of anticholinergic treatments in this population is crucial.
Non-pharmacological management strategies should be preferentially utilized for dementia care.