Key result
Anticholinergic burden score ≥3 linked to ~145% greater risk of new-onset frailty and increased sarcopenia.
Why the study?
Given the adverse effects of anticholinergic drugs, the study examined the longitudinal association between anticholinergic burden, quantified by the Japanese Anticholinergic Drug Risk Scale, and the development of frailty and sarcopenia in older adults.
Does a high anticholinergic burden increase the risk of new-onset frailty and sarcopenia in community-dwelling older adults?
Cohort (n=1,549)
No
Does a high anticholinergic burden increase the risk of new-onset frailty and sarcopenia in community-dwelling older adults?
A high anticholinergic burden is a significant predictor of new-onset frailty and sarcopenia in community-dwelling older adults.
Answers are grounded in this paper and cite their sources.
May warrant caution with high anticholinergic burden in older adults; leaves open whether reducing it prevents frailty or sarcopenia.
AIM: Given the adverse effects of anticholinergic drugs and the necessity for medication evaluation tools in the aging population, a comprehensive scale to assess the total anticholinergic burden in Japan was developed. We examined the longitudinal association between the anticholinergic burden, quantified using the Japanese Anticholinergic Drug Risk Scale, and the development of frailty and sarcopenia in older adults. METHODS: In this longitudinal population-based cohort study, 2044 older residents without long-term care needs were randomly selected from a community in Kashiwa, Japan. Baseline data were collected in 2012, with follow-ups in 2013, 2014, 2016, 2018, and 2021. Medications were identified through interviews and assessed with the Screening Tool for Older Persons' Appropriate Prescriptions for the Japanese. The anticholinergic burden was quantified using the Japanese Anticholinergic Risk Scale. We evaluated new-onset frailty and sarcopenia using the Cardiovascular Health Study Index and Asian Working Group for Sarcopenia 2019 criteria, respectively. RESULTS: Of the 1549 participants without sarcopenia or frailty at baseline (age 72.5 ± 5.5 years; 49.1% women; median follow-up 6.0 years), 274 and 230 developed new-onset frailty and sarcopenia, respectively, during follow-up. After adjusting for potential confounders, an anticholinergic burden score ≥3 was strongly associated with new-onset frailty and sarcopenia (adjusted hazard ratio [95% confidence interval]: 2.45 [1.52-3.94] and 2.01 [1.20-3.35], respectively). CONCLUSIONS: Anticholinergic burden is a predictor of frailty and sarcopenia in community-dwelling older adults. Effective evaluation and management of anticholinergic burden using the Japanese Anticholinergic Drug Risk Scale are crucial for promoting healthy aging and mitigating adverse health outcomes. Geriatr Gerontol Int 2025; 25: 520-527.
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Tanaka et al. (2025) conducted a cohort in Frailty and sarcopenia (n=1,549). Anticholinergic burden score ≥3 vs. Lower anticholinergic burden was evaluated on New-onset frailty and sarcopenia (HR 2.45 for frailty, HR 2.01 for sarcopenia, 95% CI 1.52-3.94 for frailty, 1.20-3.35 for sarcopenia). An anticholinergic burden score ≥3 was strongly associated with new-onset frailty (HR 2.45; 95% CI 1.52-3.94) and sarcopenia (HR 2.01; 95% CI 1.20-3.35) in community-dwelling older adults.
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