Anticholinergic Burden and Cognitive Function, Depressive Symptoms, and Functional Performance in Individuals With
Maria Skondra1, Leonidas Papadopoulos1, Theodora Kougioumtzoglou2,3
1Patras University Mental Health Services, Department of Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece.
Journal of Integrative Neuroscience
|July 30, 2026
Summary
Anticholinergic burden (ACB) is linked to worsened cognitive function, memory, and daily living activities in older adults. Reducing ACB may help manage cognitive decline in aging populations.
Area of Science:
- Geriatric Psychiatry
- Neuroscience
- Pharmacology
Background:
- Anticholinergic drugs negatively impact cognition and increase cognitive decline risk, especially in the elderly.
- These medications are frequently prescribed to older individuals.
- The relationship between anticholinergic burden (ACB) and cognitive/functional status needs further real-world investigation.
Purpose of the Study:
- To investigate the association between anticholinergic burden (ACB) and depressive symptoms.
- To examine the link between ACB and cognitive and functional performance in older adults.
- To explore ACB in distinct patient subgroups within a clinical setting.
Main Methods:
- Observational study at an old-age psychiatry outpatient clinic.
- Assessment of depressive symptoms (Geriatric Depression Scale).
- Evaluation of cognitive function (Cognitive Telephone Screening Instrument, MoCA, MMSE).
- Measurement of functional performance (Bristol Activities of Daily Living Scale).
- Regression and clustering analyses to explore associations and identify patient subgroups.
Main Results:
- Significant associations found between ACB and depressive symptoms, memory, attention, verbal fluency, and reasoning.
- ACB correlated negatively with cognitive function and positively with functional impairment.
- Individuals with more severe cognitive decline, functional impairment, and depressive symptoms had higher ACB.
Conclusions:
- Anticholinergic burden is associated with various aspects of the clinical presentation of cognitive decline.
- Minimizing ACB in clinical practice could be a pragmatic strategy for managing cognitive decline in aging.
- Further research is needed to establish causal relationships.
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