Does dosage reduction of anticholinergic drugs improve cognitive function in elderly nursing home residents?
Reducing serum antimuscarinic activity through dosage reduction may improve cognitive function in elderly nursing home residents.
Adverse drug reactions among elderly patients pose a significant clinical problem. The authors used a serum radioreceptor assay RRA to quantify drug-induced muscarinic blockade in 34 randomly selected nursing home residents. A random intervention group and the nonintervention control subjects were then retested 4 weeks later. The reduction of serum antimuscarinic activity (as determined by RRA) did relate to changes on several measures of cognitive function. A calculated "antimuscarinic index" lost significance with the RRA following intervention and may have overestimated the impact of a dosage reduction.
Tollefson et al. (Thu,) studied this question.