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DESIGN: electronic published and unpublished literature/trial registries were systematically reviewed.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 - Sept 2014 |
Bibliographical note
© 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.Keywords
- anti-cholinergic
- anti-muscarinic
- cholinergic antagonist
- adverse effect
- cognition
- function
- mortality
- older people
- systematic review