The cognitive impact of anticholinergics: A clinical review

Noll Campbell4, Malaz Boustani1,2,3, Tony Limbil1, Carol Ott4,5, Chris Fox6,7,8, Ian Maidment6,7, Cathy C Schubert3, Stephanie Munger1,2, Donna Fick9,10, David Miller3, Rajesh Gulati111Regenstrief Institute, Inc. Indianapolis, IN, USA; 2Indiana University Center for Aging Research; 3Department of Me...

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Autores principales:	Noll Campbell, Malaz Boustani, Tony Limbil, Carol Ott, et al.
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2009
Materias:	anticholinergic activity cognitive impairment delirium elderly Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/bf2421adee0347a09c48dead5b07c000
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spelling	oai:doaj.org-article:bf2421adee0347a09c48dead5b07c0002021-12-02T00:43:35ZThe cognitive impact of anticholinergics: A clinical review1178-1998https://doaj.org/article/bf2421adee0347a09c48dead5b07c0002009-05-01T00:00:00Zhttps://www.dovepress.com/the-cognitive-impact-of-anticholinergics-a-clinical-review-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Noll Campbell4, Malaz Boustani1,2,3, Tony Limbil1, Carol Ott4,5, Chris Fox6,7,8, Ian Maidment6,7, Cathy C Schubert3, Stephanie Munger1,2, Donna Fick9,10, David Miller3, Rajesh Gulati111Regenstrief Institute, Inc. Indianapolis, IN, USA; 2Indiana University Center for Aging Research; 3Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; 4Wishard Health Services, Indianapolis, IN, USA; 5School of Pharmacy and Pharmaceutical Sciences, Purdue University, West Lafayette, IN, USA; 6Kent Institute of Medicine and Health Sciences, University of Kent, Canterbury, Kent, UK; 7Kent and Medway NHS Trust, Dartford, Kent, UK; 8Postgraduate Medical Institute, University of Hull, Hull, UK; 9Penn State University School of Nursing; 10Department of Psychiatry, Penn State College of Medicine; 11Indiana University Medical Group – Primary Care, Indianapolis, IN, USAContext: The cognitive side effects of medications with anticholinergic activity have been documented among older adults in a variety of clinical settings. However, there has been no systematic confirmation that acute or chronic prescribing of such medications lead to transient or permanent adverse cognitive outcomes.Objective: Evaluate the existing evidence regarding the effects of anticholinergic medications on cognition in older adults.Data sources: We searched the MEDLINE, OVID, and CINAHL databases from January, 1966 to January, 2008 for eligible studies.Study selection: Studies were included if the anticholinergic activity was systematically measured and correlated with standard measurements of cognitive performance. Studies were excluded if they reported case studies, case series, editorials, and review articles.Data extraction: We extracted the method used to determine anticholinergic activity of medications and its association with cognitive outcomes.Results: Twenty-seven studies met our inclusion criteria. Serum anticholinergic assay was the main method used to determine anticholinergic activity. All but two studies found an association between the anticholinergic activity of medications and either delirium, cognitive impairment or dementia.Conclusions: Medications with anticholinergic activity negatively affect the cognitive performance of older adults. Recognizing the anticholinergic activity of certain medications may represent a potential tool to improve cognition. Keywords: anticholinergic activity, cognitive impairment, delirium, elderlyNoll CampbellMalaz BoustaniTony LimbilCarol Ottet al.Dove Medical Pressarticleanticholinergic activitycognitive impairmentdeliriumelderlyGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 4, Pp 225-233 (2009)
institution	DOAJ
collection	DOAJ
language	EN
topic	anticholinergic activity cognitive impairment delirium elderly Geriatrics RC952-954.6
spellingShingle	anticholinergic activity cognitive impairment delirium elderly Geriatrics RC952-954.6 Noll Campbell Malaz Boustani Tony Limbil Carol Ott et al. The cognitive impact of anticholinergics: A clinical review
description	Noll Campbell4, Malaz Boustani1,2,3, Tony Limbil1, Carol Ott4,5, Chris Fox6,7,8, Ian Maidment6,7, Cathy C Schubert3, Stephanie Munger1,2, Donna Fick9,10, David Miller3, Rajesh Gulati111Regenstrief Institute, Inc. Indianapolis, IN, USA; 2Indiana University Center for Aging Research; 3Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; 4Wishard Health Services, Indianapolis, IN, USA; 5School of Pharmacy and Pharmaceutical Sciences, Purdue University, West Lafayette, IN, USA; 6Kent Institute of Medicine and Health Sciences, University of Kent, Canterbury, Kent, UK; 7Kent and Medway NHS Trust, Dartford, Kent, UK; 8Postgraduate Medical Institute, University of Hull, Hull, UK; 9Penn State University School of Nursing; 10Department of Psychiatry, Penn State College of Medicine; 11Indiana University Medical Group – Primary Care, Indianapolis, IN, USAContext: The cognitive side effects of medications with anticholinergic activity have been documented among older adults in a variety of clinical settings. However, there has been no systematic confirmation that acute or chronic prescribing of such medications lead to transient or permanent adverse cognitive outcomes.Objective: Evaluate the existing evidence regarding the effects of anticholinergic medications on cognition in older adults.Data sources: We searched the MEDLINE, OVID, and CINAHL databases from January, 1966 to January, 2008 for eligible studies.Study selection: Studies were included if the anticholinergic activity was systematically measured and correlated with standard measurements of cognitive performance. Studies were excluded if they reported case studies, case series, editorials, and review articles.Data extraction: We extracted the method used to determine anticholinergic activity of medications and its association with cognitive outcomes.Results: Twenty-seven studies met our inclusion criteria. Serum anticholinergic assay was the main method used to determine anticholinergic activity. All but two studies found an association between the anticholinergic activity of medications and either delirium, cognitive impairment or dementia.Conclusions: Medications with anticholinergic activity negatively affect the cognitive performance of older adults. Recognizing the anticholinergic activity of certain medications may represent a potential tool to improve cognition. Keywords: anticholinergic activity, cognitive impairment, delirium, elderly
format	article
author	Noll Campbell Malaz Boustani Tony Limbil Carol Ott et al.
author_facet	Noll Campbell Malaz Boustani Tony Limbil Carol Ott et al.
author_sort	Noll Campbell
title	The cognitive impact of anticholinergics: A clinical review
title_short	The cognitive impact of anticholinergics: A clinical review
title_full	The cognitive impact of anticholinergics: A clinical review
title_fullStr	The cognitive impact of anticholinergics: A clinical review
title_full_unstemmed	The cognitive impact of anticholinergics: A clinical review
title_sort	cognitive impact of anticholinergics: a clinical review
publisher	Dove Medical Press
publishDate	2009
url	https://doaj.org/article/bf2421adee0347a09c48dead5b07c000
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The cognitive impact of anticholinergics: A clinical review

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