Abstract
OBJECTIVES: to determine the effect of drugs with anti-cholinergic properties on relevant health outcomes.
DESIGN: electronic published and unpublished literature/trial registries were systematically reviewed. Studies evaluating medications with anti-cholinergic activity on cognitive function, delirium, physical function or mortality were eligible.
RESULTS: forty-six studies including 60,944 participants were included. Seventy-seven percent of included studies evaluating cognitive function (n = 33) reported a significant decline in cognitive ability with increasing anti-cholinergic load (P < 0.05). Four of five included studies reported no association with delirium and increasing anti-cholinergic drug load (P > 0.05). Five of the eight included studies reported a decline in physical function in users of anti-cholinergics (P < 0.05). Three of nine studies evaluating mortality reported that the use of drugs with anti-cholinergic properties was associated with a trend towards increased mortality, but this was not statistically significant. The methodological quality of the evidence-base ranged from poor to very good.
CONCLUSION: medicines with anti-cholinergic properties have a significant adverse effect on cognitive and physical function, but limited evidence exists for delirium or mortality outcomes.
| Original language | English |
|---|---|
| Pages (from-to) | 604-615 |
| Number of pages | 12 |
| Journal | Age and Ageing |
| Volume | 43 |
| Issue number | 5 |
| Early online date | 19 Jul 2014 |
| DOIs | |
| Publication status | Published - Sep 2014 |
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Keywords
- anti-cholinergic
- anti-muscarinic
- cholinergic antagonist
- adverse effect
- cognition
- function
- mortality
- older people
- systematic review
Cite this
Effect of medications with anti-cholinergic properties on cognitive function, delirium, physical function and mortality : a systematic review. / Fox, Chris; Smith, Toby; Maidment, Ian; Chan, Wei-Yee; Bua, Nelson; Myint, Phyo Kyaw; Boustani, Malaz; Kwok, Chun Shing; Glover, Michelle; Koopmans, Imogen; Campbell, Noll.
In: Age and Ageing, Vol. 43, No. 5, 09.2014, p. 604-615.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effect of medications with anti-cholinergic properties on cognitive function, delirium, physical function and mortality
T2 - a systematic review
AU - Fox, Chris
AU - Smith, Toby
AU - Maidment, Ian
AU - Chan, Wei-Yee
AU - Bua, Nelson
AU - Myint, Phyo Kyaw
AU - Boustani, Malaz
AU - Kwok, Chun Shing
AU - Glover, Michelle
AU - Koopmans, Imogen
AU - Campbell, Noll
N1 - © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
PY - 2014/9
Y1 - 2014/9
N2 - OBJECTIVES: to determine the effect of drugs with anti-cholinergic properties on relevant health outcomes.DESIGN: electronic published and unpublished literature/trial registries were systematically reviewed. Studies evaluating medications with anti-cholinergic activity on cognitive function, delirium, physical function or mortality were eligible.RESULTS: forty-six studies including 60,944 participants were included. Seventy-seven percent of included studies evaluating cognitive function (n = 33) reported a significant decline in cognitive ability with increasing anti-cholinergic load (P < 0.05). Four of five included studies reported no association with delirium and increasing anti-cholinergic drug load (P > 0.05). Five of the eight included studies reported a decline in physical function in users of anti-cholinergics (P < 0.05). Three of nine studies evaluating mortality reported that the use of drugs with anti-cholinergic properties was associated with a trend towards increased mortality, but this was not statistically significant. The methodological quality of the evidence-base ranged from poor to very good.CONCLUSION: medicines with anti-cholinergic properties have a significant adverse effect on cognitive and physical function, but limited evidence exists for delirium or mortality outcomes.
AB - OBJECTIVES: to determine the effect of drugs with anti-cholinergic properties on relevant health outcomes.DESIGN: electronic published and unpublished literature/trial registries were systematically reviewed. Studies evaluating medications with anti-cholinergic activity on cognitive function, delirium, physical function or mortality were eligible.RESULTS: forty-six studies including 60,944 participants were included. Seventy-seven percent of included studies evaluating cognitive function (n = 33) reported a significant decline in cognitive ability with increasing anti-cholinergic load (P < 0.05). Four of five included studies reported no association with delirium and increasing anti-cholinergic drug load (P > 0.05). Five of the eight included studies reported a decline in physical function in users of anti-cholinergics (P < 0.05). Three of nine studies evaluating mortality reported that the use of drugs with anti-cholinergic properties was associated with a trend towards increased mortality, but this was not statistically significant. The methodological quality of the evidence-base ranged from poor to very good.CONCLUSION: medicines with anti-cholinergic properties have a significant adverse effect on cognitive and physical function, but limited evidence exists for delirium or mortality outcomes.
KW - anti-cholinergic
KW - anti-muscarinic
KW - cholinergic antagonist
KW - adverse effect
KW - cognition
KW - function
KW - mortality
KW - older people
KW - systematic review
U2 - 10.1093/ageing/afu096
DO - 10.1093/ageing/afu096
M3 - Article
VL - 43
SP - 604
EP - 615
JO - Age and Ageing
JF - Age and Ageing
SN - 0002-0729
IS - 5
ER -