(HealthDay News) — Anticholinergic burden (ACB) is associated with adverse outcomes in a middle- to older-aged population, according to a study published in the March/April issue of the Annals of Family Medicine.

Peter Hanlon, from University of Glasgow in the United Kingdom, and colleagues used data from the U.K. Biobank community cohort (502,538 participants; baseline age, 37 to 73 years; median years of follow-up, 6.2 years) to quantify ACB. Biobank data were linked to national mortality register records and hospital episode data.

The researchers found that anticholinergic medication use varied from 8 to 17.6% depending on the scale used. ACB was significantly associated with a composite of all-cause mortality and major adverse cardiovascular events (MACE) for each scale. The association with mortality/MACE was most strongly associated with the Anticholinergic Drug Scale (hazard ratio [HR], 1.12 per 1-point increase in score). There were also significant associations between ACB and all secondary outcomes (all-cause mortality, MACE, hospital admission for fall/fracture, and hospital admission with dementia/delirium). The association with dementia/delirium was strongest with the Anticholinergic Effect on Cognition scale (HR, 1.45 per 1-point increase).

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“Scale choice influenced the population identified as potentially requiring reduction in ACB in clinical practice or intervention trials,” the authors write.


Hanlon P, Quinn TJ, Gallacher KI, et al. Assessing Risks of Polypharmacy Involving Medications With Anticholinergic Properties. Ann Fam Med.