Author:
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
Abstract
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Design: electronic published and unpublished literature/trial registries were systematically reviewed.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.
Publisher
Oxford University Press (OUP)
Subject
Geriatrics and Gerontology,Aging,General Medicine
Cited by
254 articles.
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