title: The cognitive impact of anticholinergics: a clinical review.
abstract: BACKGROUND
  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.
  
  
  METHODS
  We searched the MEDLINE, OVID, and CINAHL databases from January, 1966 to January, 2008 for eligible studies.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors: Wishard Health Services, Indianapolis, IN, USA.
authors: Noll
authors: N
authors: Campbell
authors: Malaz
authors: M
authors: Boustani
authors: Tony
authors: T
authors: Limbil
authors: Carol
authors: C
authors: Ott
authors: Chris
authors: C
authors: Fox
authors: Ian
authors: I
authors: Maidment
authors: Cathy C
authors: CC
authors: Schubert
authors: Stephanie
authors: S
authors: Munger
authors: Donna
authors: D
authors: Fick
authors: David
authors: D
authors: Miller
authors: Rajesh
authors: R
authors: Gulati
mesh_terms: D018680:Cholinergic Antagonists / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D003072:Cognition Disorders / Q000139:chemically induced*; D003693:Delirium / Q000139:chemically induced; D006801:Humans
chemical_list: D018680:Cholinergic Antagonists