scholarly journals Anticholinergic drug burden according to the anticholinergic drug scale and the German anticholinergic burden and their impact on cognitive function in multimorbid elderly German people: a multicentre observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044230
Author(s):  
Caroline Krüger ◽  
Ingmar Schäfer ◽  
Hendrik van den Bussche ◽  
Horst Bickel ◽  
Angela Fuchs ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Drug Use ◽  
Elderly Patients ◽  
Anticholinergic Drug ◽  
Secondary Outcome ◽  
Anticholinergic Drugs ◽  
Mixed Effect ◽  
The Mean ◽  
German People ◽  
Anticholinergic Burden

ObjectivesThe aims of our study were to examine the anticholinergic drug use and to assess the association between anticholinergic burden and cognitive function in the multimorbid elderly patients of the MultiCare cohort.SettingMultiCare was conducted as a longitudinal cohort study in primary care, located in eight different study centres in Germany.Participants3189 patients (59.3% female).Primary and secondary outcome measuresBaseline data were used for the following analyses. Drugs were classified according to the well-established anticholinergic drug scale (ADS) and the recently published German anticholinergic burden (German ACB). Cognitive function was measured using a letter digit substitution test (LDST) and a mixed-effect multivariate linear regression was performed to calculate the influence of anticholinergic burden on the cognitive function.ResultsPatients used 1764 anticholinergic drugs according to ADS and 2750 anticholinergics according to the German ACB score (prevalence 38.4% and 53.7%, respectively). The mean ADS score was 0.8 (±1.3), and the mean German ACB score was 1.2 (±1.6) per patient. The most common ADS anticholinergic was furosemide (5.8%) and the most common ACB anticholinergic was metformin (13.7%). The majority of the identified anticholinergics were drugs with low anticholinergic potential: 80.2% (ADS) and 73.4% (ACB), respectively. An increasing ADS and German ACB score was associated with reduced cognitive function according to the LDST (−0.26; p=0.008 and −0.24; p=0.003, respectively).ConclusionMultimorbid elderly patients are in a high risk for using anticholinergic drugs according to ADS and German ACB score. We especially need to gain greater awareness for the contribution of drugs with low anticholinergic potential from the cardiovascular system. As anticholinergic drug use is associated with reduced cognitive function in multimorbid elderly patients, the importance of rational prescribing and also deprescribing needs to be further evaluated.Trial registration numberISRCTN89818205.

scholarly journals Comparison of FORTA, PRISCUS and EU(7)-PIM lists on identifying potentially inappropriate medication and its impact on cognitive function in multimorbid elderly German people in primary care: a multicentre observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e050344
Author(s):  
Caroline Krüger ◽  
Ingmar Schäfer ◽  
Hendrik van den Bussche ◽  
Horst Bickel ◽  
Tobias Dreischulte ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Negative Impact ◽  
Inappropriate Medication ◽  
Potentially Inappropriate Medication ◽  
Secondary Outcome ◽  
German Population ◽  
Cross Sectional ◽  
Mixed Effect ◽  
Registration Number ◽  
German People

ObjectivesOur study aimed to assess the frequency of potentially inappropriate medication (PIM) use (according to three PIM lists) and to examine the association between PIM use and cognitive function among participants in the MultiCare cohort.DesignMultiCare is conducted as a longitudinal, multicentre, observational cohort study.SettingThe MultiCare study is located in eight different study centres in Germany.Participants3189 patients (59.3% female).Primary and secondary outcome measuresThe study had a cross-sectional design using baseline data from the German MultiCare study. Prescribed and over-the-counter drugs were classified using FORTA (Fit fOR The Aged), PRISCUS (Latin for ‘time-honoured’) and EU(7)-PIM lists. A mixed-effect multivariate linear regression was performed to calculate the association between PIM use patients’ cognitive function (measured with (LDST)).ResultsPatients (3189) used 2152 FORTA PIM (mean 0.9±1.03 per patient), 936 PRISCUS PIM (0.3±0.58) and 4311 EU(7)-PIM (1.4±1.29). The most common FORTA PIM was phenprocoumon (13.8%); the most prevalent PRISCUS PIM was amitriptyline (2.8%); the most common EU(7)-PIM was omeprazole (14.0%). The lists rate PIM differently, with an overall overlap of 6.6%. Increasing use of PIM is significantly associated with reduced cognitive function that was detected with a correlation coefficient of −0.60 for FORTA PIM (p=0.002), −0.72 for PRISCUS PIM (p=0.025) and −0.44 for EU(7)-PIM (p=0.005).ConclusionWe identified PIM using FORTA, PRISCUS and EU(7)-PIM lists differently and found that PIM use is associated with cognitive impairment according to LDST, whereby the FORTA list best explained cognitive decline for the German population. These findings are consistent with a negative impact of PIM use on multimorbid elderly patient outcomes.Trial registration numberISRCTN89818205.

scholarly journals Prescribing Trends of Anticholinergic Drugs Between 1989 and 2017: A UK Biobank Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 209-209
Author(s):  
Jure Mur ◽  
Simon Cox ◽  
Riccardo Marioni ◽  
Tom Russ ◽  
Graciela Muniz Terrera
Keyword(s):  
Prescription Drugs ◽  
Anticholinergic Drug ◽  
Later Life ◽  
Anticholinergic Drugs ◽  
Uk Biobank ◽  
Linear Estimate ◽  
Cross Sectional ◽  
Increased Risk ◽  
Prescribing Trends ◽  
Anticholinergic Burden

Abstract Prescription drugs with anticholinergic properties are commonly prescribed and negatively impact physical performance, cognitive function, and increase the risk of falls and dementia. The prevalence of anticholinergic drugs is high in later life, when there is an increased risk of adverse drug effects. Recent, in-depth longitudinal analyses of specifically anticholinergic prescribing in Europe is lacking. Prescriptions for the UK-Biobank participants (n=222,122) were ascertained from primary care electronic patient records. We assigned anticholinergic activity to each drug by using a composite score. We used linear regression to study the association between current anticholinergic burden and time period, explore secular trends in anticholinergic use, and various demographic factors. We further explored the results in the context of different classes of prescriptions drugs. 74 distinct drugs in the sample (1.1%) had anticholinergic effects. An individual’s overall anticholinergic burden increased nonlinearly (linear estimate=0.474, quadratic estimate = 0.094, both p<2.2x10-16) between 1989 (mean=0.09, σ=0.009) and 2000 (mean=0.22, σ=0.006) and increased nonlinearly (linear estimate=0.282, quadratic estimate=0.074, both p<2.2x10-16) from 2000 to 2016 (mean=0.27, σ=0.009). The proportion of patients prescribed at least one anticholinergic drug per month increased from 6.1% to 16.7% from 1989 to 2000 and increased to 18.6% by 2016. When adjusted for sex and polypharmacy, age was negatively associated with recent cross-sectional anticholinergic burden (estimate=-0.042, p<2.2x10-16). Our results demonstrate an increase in prescribing of anticholinergic drugs over the past 30 years and indicate contemporary deprescribing of anticholinergic drugs in the later decades of life.

scholarly journals A meta-analysis of observational studies on anticholinergic burden and fracture risk: evaluation of conventional burden scales

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yukari Ogawa ◽  
Toshinori Hirai ◽  
Kiyoshi Mihara
Keyword(s):  
Fracture Risk ◽  
Meta Analysis ◽  
Anticholinergic Drug ◽  
Cochrane Library ◽  
Anticholinergic Drugs ◽  
Case Control Studies ◽  
Total Study Population ◽  
Burden Scale ◽  
The Relationship ◽  
Anticholinergic Burden

Abstract Background Anticholinergic burden potentially increases the risk of fracture. Although there are various anticholinergic burden scales, little is known about the inter-scale compatibility regarding the relationship of anticholinergic burden with fracture risk. We performed meta-analysis to examine the association of fracture risk with anticholinergic burden measured using various scales. Methods Primary literature was retrieved from PubMed (1966 to March, 2021), the Cochrane Library (1974 to March, 2021), Scopus (1970 to March, 2021), and Ichushi-web (1983 to March, 2021). Cohort and case-control studies that evaluated the association between any fracture and anticholinergic drugs were included. Additionally, we included studies in which patients were administered anticholinergic drugs included on the anticholinergic risk scale (ARS), anticholinergic cognitive burden (ACB), anticholinergic drug scale, or drug burden index-anticholinergic component. Random effects models were used to calculate pooled relative risk (RR) and 95% confidence interval (CI) due to heterogeneity among the studies. Publication bias was examined by funnel plots and the Begg’s test. Results A total of 49 datasets from 10 studies were included in the meta-analysis. Six of the 10 studies included only patients aged over 65 years, who accounted for 93% of the total study population (453,186/487,247). Meta-analysis indicated a positive relationship between use of anticholinergic drugs and fracture risk, regardless of the anticholinergic burden scale used. However, the relationship between anticholinergic burden and fracture risk varied depending on the scale used. Fracture risk increased linearly with increasing anticholinergic burden measured using ARS. ARS 1 point was associated with 28% increase in fracture risk, ARS 1–2 point(s) with 39%, ARS 2 points with 54%, ARS 3 points with 66%, and ARS ≥ 4 points with 77%. On the other hand, ACB 1 point and ACB 2 points were associated with similar fracture risk (pooled RR [95% CI]: overall; 1.28 [1.18–1.39], 1 point; 1.12 [1.06–1.18], 2 points; 1.15 [1.08–1.23]). Conclusions This result suggests that the relationship between anticholinergic drug burden and fracture risk may differ depending on the anticholinergic burden scale used.

scholarly journals Anticholinergic burden and cognitive functions in schizophrenia: a systematic literature review

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Giannakou ◽  
R Georgiou ◽  
D Lamnisos
Keyword(s):  
Cognitive Function ◽  
Drug Treatment ◽  
Cognitive Functions ◽  
Verbal Memory ◽  
English Language ◽  
Randomized Clinical Trials ◽  
Anticholinergic Drug ◽  
Information Processing Speed ◽  
Individual Level ◽  
Anticholinergic Burden

Abstract Background Cognitive dysfunction in schizophrenia forms the key cause of the disease's disability, leading in serious functional implications at the individual level and socioeconomic effects at global level. Dopaminergic-cholinergic balance is considered essential to cognitive function in schizophrenia while patients are often treated with many drugs with anticholinergic activity. This study aims to examine the association between high anticholinergic burden medication and cognitive function in schizophrenia patients. Methods A systematic review was performed on English language research studies published on PubMed from inception to December 2019 focusing on the effect of anticholinergic loads on cognitive domains in schizophrenia. No restrictions on study designs, age or geographical distribution were applied. Two researchers performed independently the screening and shortlisting of the eligible articles. A narrative synthesis of the main characteristics and the findings of included studies was reported. Results In total, fourteen articles of varying methodological design met the inclusion criteria. Three of them found significant improvement in cognition after anticholinergic discontinuation without adverse effects. Eleven studies found a significant association between high anticholinergic burden and cognitive impairment (e.g. verbal memory, information processing speed and working memory). However, the magnitude of the association in the largest study is statistically significant but of dubious clinical significance. Conclusions Medication with increased anticholinergic load has been found in most of the studies to affect the cognitive functions of people with schizophrenia. However, the lack of clinical and methodological homogeneity of selected studies, limit our interpretation and conclusions. Key messages There is some evidence indicating a negative effect of anticholinergic drug treatment on cognitive function of schizophrenia patients. Well-designed large prospective studies and randomized clinical trials are required to examine the effect of anticholinergic drug treatment in the cognition of schizophrenia patients.

scholarly journals A SIMPLE INTERVENTION TO REDUCE ANTICHOLINERGIC DRUG USE WHILE ATTENDING A GERIATRIC DAY HOSPITAL

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S708-S709
Author(s):  
Costa Apostolides
Keyword(s):  
Anticholinergic Drug ◽  
Intervention Group ◽  
Control Group ◽  
Day Hospital ◽  
Patient Chart ◽  
Drug Burden Index ◽  
Anticholinergic Medications ◽  
The Mean ◽  
Anticholinergic Burden ◽  
Beneficial Outcome

Abstract Attendance at a Geriatric Day Hospital has previously been shown to reduce both the overall number of medications and the number of anticholinergic medications of patients. In the present study, patients enrolled in a Geriatric Day Hospital program from January to February 2019 were divided into a control and intervention group. Anticholinergic medications in the intervention group were flagged by highlighting them in the patient chart and alerting the attending clinician, whereas no alerts were provided in the control group. Anticholinergic load was calculated using the Anticholinergic Cognitive Burden (ACB) and Drug Burden Index (DBI) scores. In comparing admit versus discharge medications in the intervention group, both the mean number of overall medications (10 vs. 9.7) and anticholinergic medications (3.5 vs. 3.1) was reduced; this was not the case in the control group, where the mean number of overall medications remained the same (11.92) and the mean number of anticholinergic medications increased (3.83 vs. 3.92). More significantly, in comparing admit versus discharge scores, both the mean ACB and DBI scores were reduced in the intervention group, but in the control group both the ACB and DBI scores either remained the same or increased at the time of discharge. This clearly shows that a simple intervention (highlighting anticholinergic medications in the patient chart) can have a clinically beneficial outcome of reducing these harmful medications in patients. With approximately 50% of the older population taking at least one anticholinergic drug, the importance of reducing anticholinergic burden cannot be overemphasized.

scholarly journals The burden of psychotropic and anticholinergic medicines use in care homes: population-based analysis in 147 care homes

2020 ◽  
Author(s):  
Paula Grill ◽  
Charis Marwick ◽  
Nicosha De Souza ◽  
Jennifer Kirsty Burton ◽  
Carmel Hughes ◽  
...  
Keyword(s):  
Oldest Old ◽  
Care Home ◽  
Anticholinergic Drug ◽  
Population Based ◽  
Care Homes ◽  
Anticholinergic Drugs ◽  
Prescription Data ◽  
People With Dementia ◽  
Psychotropic Medicines ◽  
Anticholinergic Burden

Abstract Background older people living in care-homes are particularly vulnerable to adverse effects of psychotropic and anticholinergic drugs. Methods anonymised dispensed prescription data from all 4,478 residents aged ≥ 60 years in 147 care-homes in two Scottish health boards were analysed. Psychotropic medicines examined were antipsychotics, antidepressants, hypnotic/anxiolytics, opioids and gabapentinoids. Anticholinergic burden was measured using the modified anticholinergic risk scale (mARS). Variation between care-homes and associations with individual and care-home characteristics were examined using multilevel logistic regression. Results 63.5% of residents were prescribed at least one psychotropic drug, and 27.0% two or more, most commonly antidepressants (41.6%), opioids (20.3%), hypnotic/anxiolytics (16.9%) and antipsychotics (16.7%). 48.1% were prescribed an anticholinergic drug, and 12.1% had high anticholinergic burden (mARS ≥ 3). Variation between care-homes was high for antipsychotics (intra-cluster correlation coefficient [ICC] 8.2%) and hypnotics/anxiolytics (ICC = 7.3%), and moderate for antidepressants (ICC = 4.7%) and anticholinergics (ICC = 2.8%). Prescribing of all drugs was lower in the oldest old. People with dementia were more likely to be prescribed antipsychotics (adjusted OR = 1.45, 95%CI 1.23–1.71) but less likely to be prescribed anticholinergics (aOR = 0.61, 95%CI 0.51–0.74). Prescribing of antipsychotics was higher in Tayside (aOR = 1.52, 95%CI 1.20–1.92), whereas prescribing of antidepressants (particularly tricyclic-related) was lower (aOR = 0.66, 95%CI 0.56–0.79). There was no association with care-home regulator quality scores. Conclusion care-home residents have high psychotropic and anticholinergic burden, with considerable variation between care-homes that is not related to existing measures of quality of care. Research to better understand variation between care-homes and the interaction with local prescribing cultures is needed.

scholarly journals Anti-Cholinergic Drug Burden Among Ambulatory Elderly Patients in a Nigerian Tertiary Healthcare Facility

2021 ◽  
Vol 12 ◽  
Author(s):  
Joseph O. Fadare ◽  
Abimbola Margaret Obimakinde ◽  
Felix O. Aina ◽  
Ebisola J. Araromi ◽  
Theophilus Adekunle Adegbuyi ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Anticholinergic Drug ◽  
Healthcare Facility ◽  
The Elderly ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Cross Sectional ◽  
Anticholinergic Effects ◽  
Tertiary Healthcare ◽  
Anticholinergic Burden

Background: The use of drugs with anticholinergic effects among elderly patients is associated with adverse clinical outcomes. There is paucity of information about anticholinergic drug burden among Nigerian elderly population.Objectives: To determine the anticholinergic drug burden among elderly Nigerian patients.Methods: This was a retrospective cross-sectional study conducted among elderly patients (aged 65 and above) who visited the Family Medicine outpatients’ clinics of the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria between July 1 and October 31, 2018. Information extracted from the case files included patient’s age, sex, diagnoses, and list of prescribed medications. Medicines with anticholinergic effects were identified and scored using the anticholinergic drug burden calculator (http://www.acbcalc.com).Results: The medical records of 400 patients were analyzed with females accounting for 60.5% of the study population. The mean age of participants was 73 ± 7.4 years with only 28 (7%) of patients having more than two co-morbid conditions. Polypharmacy was identified in 152 (38%) of the patients while 147 (36.7%) had drugs with anticholinergic effects prescribed. The anticholinergic burden was high in 60 (15%) patients. Polypharmacy was significantly associated with having more than two diagnosed conditions and high anticholinergic burden (p value of < 0 .001 and 0.013 respectively). There was significant correlation between total number of prescribed drugs and count of diagnoses (r = 0.598; p < 0 .000) and between total number of prescribed drugs and number of drugs with anticholinergic effects (r = 0 .196; p < 0 .000).Conclusion: The anticholinergic burden in this group of elderly Nigerian patients was low; majority (67%) had no exposure to drugs with anticholinergic effects with only 15% having high anticholinergic burden. Polypharmacy and multiple diagnosed conditions were positively associated with high anticholinergic burden. Based on the positive and significant correlations found in this study, a reduction in the number of prescribed medicines especially those with significant anticholinergic effects used for secondary indications may lessen the anticholinergic burden among the elderly.

scholarly journals Anticholinergic Burden of Geriatric Ward Inpatients

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1115
Author(s):  
Krzysztof Wilczyński ◽  
Marta Gorczyca ◽  
Jagna Gołębiowska ◽  
Jan Szewieczek
Keyword(s):  
Drug Use ◽  
Acute Care ◽  
Anticholinergic Drug ◽  
Severe Disability ◽  
Elderly Persons ◽  
Operating Characteristics ◽  
Geriatric Ward ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Anticholinergic Burden

Background and Objectives: Anticholinergic drug use in the pharmacotherapy of elderly persons is common despite the increased risk of side effects. We examined the prevalence of anticholinergic drug use and total anticholinergic drug burden among patients admitted to an acute care geriatric ward in Poland. Materials and Methods: Cross-sectional study of 329 subjects hospitalized at the geriatric ward. Patient condition was assessed with a comprehensive geriatric assessment. The Anticholinergic Cognitive Burden (ACB) scale was used to estimate the total anticholinergic load. Results: Mean patient age was 79.61 ± 6.82 years. 40.73% of them were burdened with at least one anticholinergic drug. The clinically significant anticholinergic burden was observed in 13.98% of subjects. Patients with dementia, risk of falls, and severe disability had significantly higher total ACB scores compared to other groups. The receiver operating characteristics (ROC) curve revealed that the total ACB score ≥ 1 was significantly associated with dementia and the risk of falls. Total ACB score ≥ 2 was significantly associated with severe disability. Conclusions: Patients admitted to an acute care geriatric ward had an anticholinergic cognitive burden score comparable to other patient populations. We found associations at both low and elevated levels of anticholinergic burden with dementia and risk of falls. At elevated anticholinergic burden levels, we found associations with severe disability. Despite recommendations against the use of anticholinergics in older adults these medications are still commonly prescribed. Further study is necessary to define the characteristics of anticholinergic medication most closely associated with negative outcomes in elderly populations.

Association between anti-cholinergic burden and delirium among patients with advanced cancer referred to a palliative care consult service.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 213-213
Author(s):  
Maxine Grace Jaucian De La Cruz ◽  
Joseph Baidoo ◽  
Vishidha Reddy Balankari ◽  
Jessica Marie Waletich-Flemming ◽  
Marvin Delgado-Guay ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advanced Cancer ◽  
Hematologic Malignancy ◽  
Demographic Data ◽  
Anticholinergic Drug ◽  
Univariate Analysis ◽  
Anticholinergic Drugs ◽  
Logistic Regression Models ◽  
Chi Squared ◽  
Anticholinergic Burden

213 Background: Delirium occurs in about 45-60% hospitalized patients and 80-85% at the end of life. Predisposing factors include anti-cholinergic medications as is often cited in the geriatric literature. Our study aimed to demonstrate the association of anti-cholinergic burden and delirium in patients with advanced cancer. Methods: Retrospective review of 775 consecutive patients seen by the palliative care inpatient consult team. Demographic data, MDAS, ECOG, and anti-cholinergic drugs were determined. Anticholinergic burden was measured using the anticholinergic drug scale (ADS), anticholinergic risk scale (ARS), and anticholinergic burden scale (ACB). Patients with delirium and those who did not develop delirium were compared. Association between delirium and anticholinergic use were analyzed using Chi-squared test, univariate and multivariate logistic regression models. Results: 270/775 (35%) had delirium at the time of consult. Median age was 58 years. The median total of anticholinergic drugs in both groups was 6. Anticholinergic burden using the ADS (median 2 vs. 3; p = 0.09) and ARS (median 0 vs. 1; p = 0.75) was not different in both groups. ACB score were significantly different in both groups (median 1 vs 2; p = 0.0006). Univariate analysis showed hematologic malignancy (OR = 1.85, 95%CI: (1.23, 2.77), p 0.0030, poor ECOG, age (OR = 1.03, 95%CI: (1.02, 1.04), p < 0.0001) and ACB score (OR = 1.11, 95%CI: (1.03, 1.21), p 0.0069 to be associated with delirium. In our multivariate model ECOG (OR = 0.25, 95% CI: (0.17, 0.36), p < 0.0001), and age (OR = 1.03, 95% CI: (1.01, 1.04), p < 0.0001) are the only independent covariates significantly associated with the presence of delirium at admission. Conclusions: Our study found that in this younger population with cancer, the total number of anticholinergic drugs and the anticholinergic burden using 3 different scales were not associated with delirium suggesting a different mechanism. Further studies are needed to confirm these findings.

scholarly journals ANTICHOLINERGIC DRUGS: CUT-OFF FOR IMPAIRED COGNITION AND MOBILITY IN SENIORS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S92-S93
Author(s):  
Elpidio K ATTOH-MENSAH ◽  
Gilles Loggia ◽  
Remy Morello ◽  
Pascale Schumann-Bard ◽  
Pablo Descatoire ◽  
...  
Keyword(s):  
Drug Prescription ◽  
Anticholinergic Drug ◽  
Threshold Value ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Anticholinergic Drugs ◽  
Operating Characteristics ◽  
Daily Consumption ◽  
Impaired Cognition ◽  
Anticholinergic Burden

Abstract Background and Objectives: Anticholinergic drugs are commonly prescribed in older adults despite growing evidence of their adverse outcomes. We aimed to improve knowledge about deleterious effects of anticholinergic drugs on both cognition and mobility, in particular whether there is a threshold value for the number of anticholinergic drugs or for the anticholinergic burden leading to mobility or cognitive impairment. Methods: 177 community-dwelling individuals aged 55 years or over, with a fall history in the previous year, took part in the study. Anticholinergic drugs were identified using the Anticholinergic Drug Scale (ADS), and global cognition and mobility were assessed using the Mini Mental State Examination (MMSE) and the Time-Up-and-Go (TUG) test, respectively. Results: ROC (Receiver Operating Characteristics) curve analysis indicated that consumption of a single anticholinergic drug per day was a risk factor for impaired MMSE (p &lt; .05) and TUG scores (p &lt; .05). There was also a cut-off of anticholinergic burden of one for impaired MMSE scores (p &lt; .05). Logistic regressions showed that impaired cognition induced by anticholinergic drugs were independent of confounding factors including comorbidities, while impaired mobility would be influenced by age and cardiac comorbidities. Conclusion: Daily consumption of a single anticholinergic drug, regardless of its anticholinergic burden, impairs both cognition and mobility community-dwelling seniors. Alternative solutions to anticholinergic drug prescription should thus be considered whenever possible.

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