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May 21, 2019Irish Journal of Psychological Medicine

The mean ACB score was 2.2, with 37.9% having a clinically significant score (>3); a significantly greater number of medications with anticholinergic activity were identified using the composite list versus the traditional ACB scale (2.3 vs 1.5, p=0.001).

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Why the study?

Older adults with dementia are particularly vulnerable to adverse outcomes from anticholinergic use, prompting evaluation of anticholinergic burden and co-prescription with acetylcholinesterase inhibitors.

Population

66 new referrals with dementia attending a Psychiatry of Later Life service

Comparison

ACB scale vs composite list of anticholinergics

Design

Retrospective chart review

Authors

RVR. M. VaughanRFR. FlynnNGN. Greene

Discussion

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Overview

Significant anticholinergic burden in dementia may be underestimated by traditional scales; hypothesis-generating for composite lists before practice change.

Structured PICO

P
Population
New referrals with a diagnosis of dementia (n=66) seen by the Psychiatry of Later Life (PLL) service, Tallaght University Hospital, Dublin, Ireland
I
Intervention
Assessment of anticholinergic burden using the Anticholinergic Cognitive Burden (ACB) scale and a composite list of anticholinergics
O
Outcome
Anticholinergic burden (ACB score) and comparison of medications identified by ACB scale versus a composite list

Patients with dementia attending a specialist service have a significant anticholinergic burden, which may be underestimated by the traditional ACB scale alone.

Cite This Study

Vaughan et al. (2019) studied this question.

synapsesocial.com/papers/6a80fef1e6814737203bf2d6https://doi.org/10.1017/ipm.2019.20
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A Drug Burden Index to Define the Functional Burden of Medications in Older People2007 · 774 citations
  2. 2The Anticholinergic Drug Scale as a Measure of Drug‐Related Anticholinergic Burden: Associations With Serum Anticholinergic Activity2006 · 677 citations
  3. 3Comparison of Anticholinergic Risk Scales and Associations with Adverse Health Outcomes in Older People2015 · 178 citations
  4. 4Anticholinergic Medication Use and Cognitive Impairment in the Older Population: The Medical Research Council Cognitive Function and Ageing Study2011 · 650 citations