Anticholinergic Risk Scale (ARS)

Several studies investigated the possible association between anticholinergic drugs and diverse clinical outcomes in older persons, but the results are inconsistent. The aim of this study was to investigate whether anticholinergic drug exposure is associated with delirium on admission, length of hospital stay, postdischarge institutionalization and in-hospital mortality in acutely ill hospitalized older patients. In this observational chart review study, we included acutely ill patients aged 65 and older who were admitted to the geriatric ward of the Erasmus University Medical Center, Rotterdam, The Netherlands, between 2012 and 2015 ( n  = 905)...

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...

OBJECTIVES: To determine whether heat waves (HWs) affect exposure to drugs with anticholinergic effects (DACEs) on admission and the effect of such on length of stay (LOS) and in-hospital mortality in older adults. DESIGN: Retrospective. SETTING: Metropolitan teaching hospital. PARTICIPANTS: Individuals aged 65 and older with at least one chronic condition (n = 307) admitted to a medical ward during five consecutive HWs (≥5 consecutive days of a maximum temperature of ≥35 °C or ≥3 consecutive days of a maximum temperature of ≥40 °C) recorded between 2007 and 2009...

OBJECTIVES: To determine primary care physician (PCP) acceptance rates of electronic medication therapy recommendations based on anticholinergic burden for high-risk elderly patients, and to evaluate potential associations between recommendation acceptance and patient-provider characteristics. SETTING: Two medical clinics within Dean Health System, an integrated health care organization comprising ambulatory surgery centers, medical clinics, community pharmacies, specialty pharmacies, a health plan, and a pharmacy benefits management company...

BACKGROUND: Elderly adults should avoid medications with anticholinergic effects since they may increase the risk of adverse events, including falls, delirium, and cognitive impairment. However, data on anticholinergic burden are limited in subpopulations, such as individuals with Parkinson disease (PD). The objective of this study was to determine whether anticholinergic burden was associated with adverse outcomes in a PD inpatient population. METHODS: Using the Cerner Health Facts® database, we retrospectively examined anticholinergic medication use, diagnoses, and hospital revisits within a cohort of 16,302 PD inpatients admitted to a Cerner hospital between 2000 and 2011...

PURPOSE: Anticholinergic drugs may increase the risk of cognitive and functional disorders in older patients. There are anticholinergic scales on which said risk is estimated. The objectives of this study are: to identify the scales described in literature that are applicable to polypathological patients and analyze their clinical outcomes. MATERIAL AND METHODS: A systematic review was performed. Data sources were MEDLINE, EMBASE and Web of Science which were consulted until August 2014...

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))...

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)...

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...

INTRODUCTION AND HYPOTHESIS: Our aim was to evaluate the impact of anticholinergic load on urinary retention based on postvoid residual (PVR) on micturition study. Secondary objectives were to assess the effect of anticholinergic load on other urodynamic parameters. METHODS: This was a retrospective cohort study of women who underwent urodynamics (UDS) at one academic institution. All medications being taken by the women at the time of UDS were scored using the anticholinergic risk scale (ARS)...

AIM: Increasing evidence from experimental studies and clinical observations suggests that drugs with anticholinergic properties can cause physical and mental impairment. The aim of the present study was to evaluate the relationship between the use of drugs with anticholinergic activity and negative outcomes in older nursing home residents. METHODS: We used data from the database of the U.L.I.S.S.E project (Un Link Informatico sui Servizi Sanitari Esistenti per l'Anziani), a prospective multicenter observational study...

OBJECTIVE: To compare associations between four measures of anticholinergic exposure (anticholinergic risk scale, ARS; anticholinergic drug burden, DBAC; number and use versus no use of anticholinergic drugs), Barthel Index (BI, physical function) and Abbreviated Mental Test (AMT, cognitive function) on admission in older hospitalized patients. METHODS: Prospective observational study of a consecutive series of 271 older patients (age 83 ± 7 years) from community-dwelling and institutionalized settings, admitted to an acute geriatric admission unit between 28 September 2011 and 18 December 2011...

INTRODUCTION: Anticholinergic drugs are associated with poor outcomes in older patients but no specific intervention strategies aimed at reducing anticholinergic drug exposure have been described. OBJECTIVES: To identify whether a consultant-led medication review targeting anticholinergics would reduce anticholinergic drug exposure [number of anticholinergic drugs and Anticholinergic Risk Scale (ARS) score]. METHODS: The first phase of the audit included 70 consecutive admissions (mean age 84 years, 53 women)...

Acetylcholine is one of the main neurotransmitters. It is involved in autonomic activities of the peripheral organs and forms a part of complicated neural networks in the central nervous system. Anticholinergic drugs are used in the treatment of various diseases, and many drugs have anticholinergic side effects. Thus, estimating the total burden of anticholinergic activity of drugs is important to assess the related adverse effects for patients taking such drugs. Serum anticholinergic activity (SAA) is measured using a competitive radioreceptor binding assay of muscarinic receptors...

OBJECTIVE: This study aimed to examine how anticholinergic medication exposure affects the risk of failed postoperative void trial (VT) in women undergoing urogynecologic surgery. METHODS: We conducted a retrospective cohort study of women undergoing outpatient prolapse or incontinence surgery. We evaluated perioperative anticholinergic exposure via the validated anticholinergic risk scale (ARS). Total ARS score was calculated by summing the individual ARS for each medication used during the following periods: at home before surgery, in preoperative holding, intraoperatively, and in postoperative recovery...

OBJECTIVE: Determine the association between different measures of drug exposure such as an increased Drug Burden Index (DBI) and a higher Anticholinergic Risk Scale (ARS) score in vulnerable elders and risk of readmission to the hospital. DESIGN: The study is a retrospective cohort comparing ARS and DBI between patients readmitted and not readmitted to the hospital within 30 days of initial admission. Data collected included drugs considered to have anticholinergic, sedative, or both types of properties (Appendix 1), medication strengths, doses per day, patient age, Vulnerable Elders Survey (VES-13) score upon admission, patient diagnoses, and rates of admission...

OBJECTIVES: To describe the frequency of medication-related problems in older adults with human immunodeficiency virus (HIV) infection. DESIGN: Retrospective chart review. SETTING: Community. PARTICIPANTS: HIV-positive individuals aged 60 and older and age- and sex-matched HIV-negative individuals. MEASUREMENTS: Total number of medications, potentially inappropriate medications (PIMs) according to the modified Beers Criteria, anticholinergic drug burden according to the Anticholinergic Risk Scale (ARS), and drug-drug interactions using the Lexi-Interact online drug interactions database...

OBJECTIVES: To compare the effect of using different anticholinergic drug scales and different models of cognitive decline in longitudinal studies. DESIGN: Longitudinal cohort study. SETTING: Outpatient clinics, Quebec, Canada. PARTICIPANTS: Individuals aged 60 and older without dementia or depression (n = 102). MEASUREMENTS: Using baseline and 1-year follow-up data, four measures of anticholinergic burden (anticholinergic component of the Drug Burden Index (DBI-Ach), Anticholinergic Cognitive Burden (ACB), Anticholinergic Drug Scale (ADS), and Anticholinergic Risk Scale (ARS)) were applied...

BACKGROUND: in older people, medications with anticholinergic (antimuscarinic) effects are associated with adverse clinical outcomes, the risk increasing with increasing anticholinergic exposure. Many anticholinergics are recognised as potentially inappropriate and efforts to reduce prescription have been ongoing. We examined temporal trends of anticholinergic prescription and exposure in older people. METHODS: : anonymised data on all prescribed medication dispensed to people ≥65 years in Tayside, Scotland were obtained for the years 1995 (n = 67,608) and 2010 (n = 73,465)...

BACKGROUND: Dementia is a disorder that is characterized by a chronic, progressive loss of cognitive function. Anticholinergic agents that are often used with elderly patients may cause a decline in cognitive capacity; therefore, they must be used with caution. OBJECTIVE: We aimed to identify the prescription patterns for anticholinergic drugs in elderly outpatients with a documented diagnosis of dementia through a retrospective analysis of electronic medical records...