Managing drugs with anticholinergic activity
1Mental Health of Older Adults and Dementia, South London and Maudsley NHS Foundation Trust, London, UK Delia.Bishara@slam.nhs.uk.
Drug and Therapeutics Bulletin
|August 30, 2023
Summary
Anticholinergic drugs can cause serious side effects in older adults, including cognitive decline and dementia. Prescribers should carefully consider these risks to protect vulnerable patients.
Area of Science:
- Gerontology
- Pharmacology
- Neuroscience
Background:
- Growing evidence links anticholinergic medications to adverse effects in the elderly.
- Common side effects include dry mouth, blurred vision, constipation, and urinary retention.
Purpose of the Study:
- To review the association between anticholinergic drug use and adverse outcomes in older adults.
- To discuss tools for identifying high-risk anticholinergic medications.
- To provide guidance for prescribers to mitigate risks.
Main Methods:
- Literature review of studies on anticholinergic activity and adverse effects in older populations.
- Discussion of validated tools for anticholinergic burden assessment.
- Analysis of prescribing considerations for high-risk individuals.
Main Results:
- Long-term anticholinergic drug use is linked to cognitive decline, increased dementia incidence, and mortality.
- Several tools exist to identify drugs with significant anticholinergic properties.
- Risk is elevated in older individuals, particularly those with cognitive impairment.
Conclusions:
- Anticholinergic medications pose significant risks to older adults, especially concerning cognitive function.
- Awareness and careful prescribing are crucial to minimize adverse events.
- Further research and clinical vigilance are needed to manage these risks effectively.
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