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Anticholinergic burden of patients with dementia attending a Psychiatry of Later Life service.
Vaughan, R M; Flynn, R; Greene, N.
Affiliation
  • Vaughan RM; Psychiatry of Later Life, Tallaght University Hospital, Dublin 24, Ireland.
  • Flynn R; Psychiatry of Later Life and School of Medicine, Trinity College Dublin, Dublin, Ireland.
  • Greene N; Psychiatry of Later Life, Tallaght University Hospital, Dublin 24, Ireland.
Ir J Psychol Med ; 39(1): 39-44, 2022 03.
Article in En | MEDLINE | ID: mdl-31112109
OBJECTIVES: Older adults with dementia are particularly vulnerable to adverse outcomes resulting from anticholinergic use. We aimed to: (i) Examine the anticholinergic burden of patients with dementia attending a Psychiatry of Later Life (PLL) service (ii) Examine concomitant prescription of acetylcholinesterase inhibitors (AChEIs) and anticholinergics and (iii) Compare the Anticholinergic Cognitive Burden (ACB) scale with a recently published composite list of anticholinergics. METHODS: Retrospective chart review of new referrals with a diagnosis of dementia (n = 66) seen by the PLL service, Tallaght University Hospital, Dublin, Ireland, over a consecutive period of 4 months. RESULTS: The mean ACB score was 2.2 (range = 0-9, SD = 2.1). 37.9% (n = 25) had a clinically significant ACB score (>3) and 42.1% (n = 8) of those taking AChEIs had a clinically significant ACB score. A significantly greater number of medications with anticholinergic activity were identified using the composite list versus the traditional ACB scale (2.3 v.1.5, p = 0.001). CONCLUSIONS: We demonstrated a significant anticholinergic burden amongst patients with dementia attending a specialist PLL service. There was no difference in anticholinergic burden between groups prescribed and not prescribed AChEIs, indicating that these medications are being prescribed without discontinuation of potentially inappropriate medications with anticholinergic activity. The true anticholinergic burden experienced by patients may be underestimated by the use of the ACB score alone, although the clinical significance of this finding is unclear. Calculation of true clinical anticholinergic burden load and its translation to a specific rating scale remains a challenge.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Psychiatry / Dementia Type of study: Observational_studies / Prognostic_studies Limits: Aged / Humans Language: En Journal: Ir J Psychol Med Year: 2022 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Psychiatry / Dementia Type of study: Observational_studies / Prognostic_studies Limits: Aged / Humans Language: En Journal: Ir J Psychol Med Year: 2022 Document type: Article Affiliation country: Country of publication: