The cognitive impact of anticholinergics:a clinical review


Context: 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.

Publication DOI:
Divisions: College of Health & Life Sciences > Aston Pharmacy School
College of Health & Life Sciences > Chronic and Communicable Conditions
Additional Information: © 2009 Campbell et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.
Uncontrolled Keywords: cholinergic antagonists,cognition disorders,delirium,humans,anticholinergic activity,cognitive impairment,elderly,Geriatrics and Gerontology
Publication ISSN: 1178-1998
Last Modified: 27 May 2024 07:10
Date Deposited: 11 Mar 2019 18:18
Full Text Link: http://www.dove ... wed-article-CIA
Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2009-05
Authors: Campbell, Noll
Boustani, Malaz
Limbil, Tony
Ott, Carol
Fox, Chris
Maidment, Ian (ORCID Profile 0000-0003-4152-9704)
Schubert, Cathy C.
Munger, Stephanie
Fick, Donna
Miller, David
Gulati, Rajesh



Version: Published Version

License: Creative Commons Attribution

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