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Anticholinergic Drug Scale (ADS)

Yacine Jaïdi, Adrien Guilloteau, Vignon Nonnonhou, Laurie-Anne Bertholon, Sarah Badr, Isabella Morrone, Jean-Luc Novella, Rachid Mahmoudi
BACKGROUND: A high anticholinergic burden (AB) is associated with the occurrence of behavioral and psychological symptoms (BPSDs), which are frequent in dementia. OBJECTIVES: Our aim was to determine the threshold for a reduction in AB that would lead to a clinically significant improvement in BPSDs (in terms of frequency, severity, and disruptiveness). DESIGN: A single-center prospective study. SETTINGS: Dedicated geriatric care unit specializing in the management of patients with dementia...
November 28, 2018: Journal of the American Medical Directors Association
Elodie Jean-Bart, Claire Moutet, Virginie Dauphinot, Pierre Krolak-Salmon, Christelle Mouchoux
Background There are several assessment scales to evaluate the risk of falls or the adverse drug reaction risk. Few are sufficiently specific to assess the impact of drug prescriptions on falls in geriatric populations. Objective To define the risk of anticholinergic and sedation-related ADRs in an elderly hospitalized patient population using the Drug Burden Index (DBI), Anticholinergic Drug Scale (ADS), and Sedative Load Model (SLM). Setting Five geriatric university hospital centers in France. Method Multicenter prospective cohort study from 2011 to 2013...
December 2017: International Journal of Clinical Pharmacy
Antti Tiisanoja, Anna-Maija Syrjälä, Kaija Komulainen, Pasi Lampela, Sirpa Hartikainen, Heidi Taipale, Matti Knuuttila, Pekka Ylöstalo
OBJECTIVE: The aim was to study whether the anticholinergic burden of drugs is related to xerostomia and salivary secretion among community-dwelling elderly people. BACKGROUND: Anticholinergic drugs have been shown to be a risk factor for dry mouth, but little is known about the effects of cumulative exposure to anticholinergic drugs measured by anticholinergic burden on salivary secretion or xerostomia. METHODS: The study population consisted of 152 community-dwelling, dentate, non-smoking, older people from the Oral Health GeMS study...
March 2018: Gerodontology
Virginie Dauphinot, Christelle Mouchoux, Sébastien Veillard, Floriane Delphin-Combe, Pierre Krolak-Salmon
BACKGROUND: Drugs with anticholinergic properties may be associated with various adverse clinical effects. The relationship between the anticholinergic (AC) burden and functional, global cognitive performance and behavior disturbances was assessed among elderly patients. METHODS: A cross-sectional study was conducted between January 2012 and June 2014 in a memory clinic among outpatients living at home and with subjective cognitive decline (SCD) or neurocognitive disorders (NCD)...
August 1, 2017: Alzheimer's Research & Therapy
Satabdi Chatterjee, Vishal Bali, Ryan M Carnahan, Hua Chen, Michael L Johnson, Rajender R Aparasu
BACKGROUND: Few studies have evaluated the association between anticholinergic use and mortality in elderly nursing home residents. OBJECTIVE: The aim of this study was to examine the risk of mortality associated with anticholinergic use among elderly nursing home residents with depression. METHODS: The study employed a population-based nested case-control design using 2007-2010 Minimum Data Set (MDS)-linked Medicare data from all states. The base cohort included Medicare beneficiaries aged ≥65 years, diagnosed with depression as of 2007, and with any MDS assessment in 2007...
September 2017: Drugs & Aging
Anne Sverdrup Efjestad, Hege Ihle-Hansen, Vidar Hjellvik, Hege Salvesen Blix
BACKGROUND/AIMS: Reduced clinical effect on cognitive decline in dementia by acetylcholinesterase inhibitors (AChEIs) may be due to concurrent use of drugs with anticholinergic properties. The aim was to analyze the incidence of AChEI use and comedication with drugs with anticholinergic properties and other potential unfavorable effects. METHODS: A prospective study applying drug use data from the Norwegian Prescription Database. Anticholinergic Drug Scale (ADS) scores were used as a measure of overall anticholinergic burden...
January 2017: Dementia and Geriatric Cognitive Disorders Extra
Seenae Eum, S Kristian Hill, Leah H Rubin, Ryan M Carnahan, James L Reilly, Elena I Ivleva, Sarah K Keedy, Carol A Tamminga, Godfrey D Pearlson, Brett A Clementz, Elliot S Gershon, Matcheri S Keshavan, Richard S E Keefe, John A Sweeney, Jeffrey R Bishop
BACKGROUND: Patients with psychotic disorders are often treated with numerous medications, many of which have anticholinergic activity. We assessed cognition in relation to the cumulative anticholinergic burden of multiple drugs included in treatment regimens of participants from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) study. METHOD: Clinically stable participants with schizophrenia (n=206), schizoaffective disorder (n=131), and psychotic bipolar disorder (n=146) were examined...
December 2017: Schizophrenia Research
Michele S S Lee, Hugh C Hanger
BACKGROUND/AIM: In patients discharged from an Older Person's Health hospital, we assessed (i) the prevalence of anticholinergic medications (ACM) in this study population and (ii) changes in anticholinergic drug burden during admission using the Anticholinergic Drug Scale (ADS). METHODS: Cases were identified between September 2010 and January 2011 using discharge coding data. Clinical notes were reviewed to determine which regular oral medications were commenced, altered or ceased during admission with their respective ADS level...
June 2017: Internal Medicine Journal
Daniel Sevilla-Sanchez, Núria Molist-Brunet, Jordi Amblàs-Novellas, Pere Roura-Poch, Joan Espaulella-Panicot, Carles Codina-Jané
PURPOSE: Adverse drug events (ADEs) lead to adverse clinical outcomes such as hospitalization. There is little information about the characteristics of ADEs in patients with advanced chronic conditions and have a prognosis of limited life expectancy. This study aimed to evaluate (i) the prevalence of ADEs at the time of admission to hospital, (ii) the causality, severity, and preventability of the ADEs, and (iii) the clinical and pharmacological characteristics associated with the ADEs...
January 2017: European Journal of Clinical Pharmacology
Hannah C Moorey, Sebastian Zaidman, Thomas A Jackson
BACKGROUND: Older people are commonly prescribed multiple medications, including medications with anticholinergic effects. Polypharmacy and anticholinergic medications may be risk factors for the development of delirium. METHODS: Patients from a medical admission unit who were over 70, with DSM-IV diagnosed delirium and patients without delirium, were investigated. Number of drugs prescribed on admission and anticholinergic burden using two scales (the Anticholinergic Cognitive Burden Scale [ACB] and the Anticholinergic Drug Scale [ADS]) were recorded from electronic prescribing records...
September 21, 2016: BMC Geriatrics
P J Magin, S Morgan, A Tapley, C McCowan, L Parkinson, K M Henderson, C Muth, M S Hammer, D Pond, K E Mate, N A Spike, L A McArthur, M L van Driel
WHAT IS KNOWN AND OBJECTIVES: Adverse clinical outcomes have been associated with cumulative anticholinergic burden (to which low-potency as well as high-potency anticholinergic medicines contribute). The clinical indications for which anticholinergic medicines are prescribed (and thus the 'phenotype' of patients with anticholinergic burden) have not been established. We sought to establish the overall prevalence of prescribing of anticholinergic medicines, the prevalence of prescribing of low-, medium- and high-potency anticholinergic medicines, and the clinical indications for which the medicines were prescribed in an older primary care population...
October 2016: Journal of Clinical Pharmacy and Therapeutics
Satabdi Chatterjee, Vishal Bali, Ryan M Carnahan, Hua Chen, Michael L Johnson, Rajender R Aparasu
Limited research exists regarding the effect of anticholinergics on falls and fractures in elderly nursing home residents in the United States. This study examined the risk of fractures associated with anticholinergic medication use in elderly nursing home residents with depression. A nested case-control design involving a cohort of elderly adults with depression from the 2007 to 2010 Minimum Data Set (MDS)-linked Medicare data was used to evaluate the risk of fractures. The study sample included Medicare beneficiaries aged 65 and older diagnosed with depression having at least one nursing home stay during 2007 to 2010 and no history of falls or fractures in 2007 (base period)...
July 2016: Journal of the American Geriatrics Society
Aurora M Rojo-Sanchís, Manuel Vélez-Díaz-Pallarés, María Muñoz García, Eva Delgado Silveira, Teresa Bermejo Vicedo, Alfonso Cruz Jentoft
BACKGROUND: The use of anticholinergic drugs in the elderly has been associated to an increased frequency of delirium. There are different scales for estimating the anticholinergic burden, such as the Anticholinergic Drug Scale (ADS), Anticholinergic Risk Scale (ARS), and Anticholinergic Cognitive Burden (ACB). The aim of the study is to establish the relationship between anticholinergic burden measured by ADS, ARS, and ACB scales and incident or prevalent delirium. METHODS: An ambispective observational study was conducted for 76 days in the acute geriatric unit of a tertiary hospital...
July 2016: Revista Española de Geriatría y Gerontología
Satabdi Chatterjee, Ryan M Carnahan, Hua Chen, Holly M Holmes, Michael L Johnson, Rajender R Aparasu
OBJECTIVES: To examine the risk of community-acquired pneumonia (CAP) associated with the use of anticholinergic medications in elderly adults. DESIGN: Nested case-control study. SETTING: A regional Medicare Advantage healthcare plan (2009-2010). PARTICIPANTS: Participants were Medicare Advantage Plan enrollees aged 65 and older with at least one inpatient and one outpatient claim with no history of CAP between January 1 and June 30, 2009...
February 2016: Journal of the American Geriatrics Society
J Di Marco, C De Broglie, P Manceau, L Weglinski, F Le Breton, D Verrollet, G Amarenco
AIM: Determine if the initiation of an anticholinergic treatment affects the sexual function in women diagnosed with multiple sclerosis (MS). METHODS: It was a single-centre prospective open label study on 18 women affected by MS, with a clinical overactive bladder syndrome, and examined before and after anticholinergic treatment. Several variables were studied before and after treatment: the total anticholinergic load (Anticholinergic Drug Scale [ADS]), the Female Sexual Function Index, the Urinary Symptom Profile (USP) and functional status (EDSS, MIF)...
March 2016: Progrès en Urologie
Jennifer G Naples, Zachary A Marcum, Subashan Perera, Shelly L Gray, Anne B Newman, Eleanor M Simonsick, Kristine Yaffe, Ronald I Shorr, Joseph T Hanlon
OBJECTIVES: To evaluate concordance of five commonly used anticholinergic scales. DESIGN: Cross-sectional secondary analysis. SETTING: Pittsburgh, Pennsylvania, and Memphis, Tennessee. PARTICIPANTS: Community-dwelling adults aged 70 to 79 with baseline medication data from the Health, Aging, and Body Composition Study (N = 3,055). MEASUREMENTS: Any anticholinergic use, weighted scores, and total standardized daily dosage were calculated using five anticholinergic measures (Anticholinergic Cognitive Burden (ACB) Scale, Anticholinergic Drug Scale (ADS), Anticholinergic Risk Scale (ARS), Drug Burden Index anticholinergic component (DBI-ACh), and Summated Anticholinergic Medications Scale (SAMS))...
October 2015: Journal of the American Geriatrics Society
Alison J Yarnall, Rachael A Lawson, Gordon W Duncan, David P Breen, Tien K Khoo, David Brooks, Roger A Barker, John-Paul Taylor, David J Burn
We evaluated the effect of anticholinergic burden on 219 participants with incident Parkinson's disease (PD) and 99 controls at study baseline and 18 months. Anticholinergic burden for each individual was calculated and summed according to the Anticholinergic Drug Scale (ADS). Medication with anticholinergic activity was more commonly prescribed in PD compared to controls, although mean ADS scores were not significantly different. Cognitive scores did not differ in PD participants taking medications with anticholinergic activity compared to those who were not...
2015: Journal of Parkinson's Disease
François Montastruc, Sarah Rouanet, Virginie Gardette, Vanessa Rousseau, Haleh Bagheri, Jean-Louis Montastruc
AIM: Atropinic drugs in patients with Alzheimer disease (AD) can decrease the effects of anticholinesterase drugs and/or induce adverse drug reactions (ADRs). Several atropinic risk scales defining an atropinic burden of drugs were proposed but were little used in AD patients. METHODS: All ADRs' notifications of AD patients registered in the Midi-Pyrénées PharmacoVigilance Database between 1999 and 2013 were analyzed using Anticholinergic Drug Scale (ADS) and Anticholinergic Duran's list...
July 2015: European Journal of Clinical Pharmacology
Lisa G Pont, Johannes T H Nielen, Andrew J McLachlan, Danijela Gnjidic, Lewis Chan, Robert G Cumming, Katja Taxis
AIMS: Anticholinergic drug exposure is associated with adverse outcomes in older people. While a number of tools have been developed to measure anticholinergic drug exposure, there is limited information about the agreement and overlap between the various scales. The aim of this study was to investigate the agreement and overlap between different measures of anticholinergic drug exposure in a cohort of community-dwelling older men. METHODS: A cross-sectional study was used to compare anticholinergic drug exposure calculated using the Anticholinergic Risk Scale (ARS), the Anticholinergic Drug Scale (ADS), the Anticholinergic Cognitive Burden (ACB) and the Drug Burden Index anticholinergic subscale (DBI-ACH) in a cohort of community-dwelling men aged 70 years and older (n = 1696)...
November 2015: British Journal of Clinical Pharmacology
Kimberley Ruxton, Richard J Woodman, Arduino A Mangoni
AIM: The aim was to investigate associations between drugs with anticholinergic effects (DACEs) and cognitive impairment, falls and all-cause mortality in older adults. METHODS: A literature search using CINAHL, Cochrane Library, Embase and PubMed databases was conducted for randomized controlled trials, prospective and retrospective cohort and case-control studies examining the use of DACEs in subjects ≥65 years with outcomes on falls, cognitive impairment and all-cause mortality...
August 2015: British Journal of Clinical Pharmacology
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