anticholinergic burden
Cumulative effect of multiple medications with anticholinergic properties, increasing risk of cognitive impairment and delirium in older adults.
Full Definition
Anticholinergic burden refers to the cumulative exposure to medications that block acetylcholine receptors, which can significantly impact cognitive function and increase delirium risk in elderly patients. Many commonly prescribed medications possess anticholinergic properties, including certain antidepressants, antihistamines, antispasmodics, and antipsychotics. The burden is typically quantified using validated scales such as the Anticholinergic Cognitive Burden (ACB) scale or Drug Burden Index. Higher anticholinergic burden is associated with increased risk of falls, cognitive decline, constipation, urinary retention, and mortality in older adults. In geriatric psychiatry, assessment of anticholinergic burden is crucial during medication reviews, as even medications prescribed for psychiatric conditions can contribute to cognitive deterioration. Clinical management involves identifying high-burden medications and considering alternatives with lower anticholinergic activity.
Usage
Usage note: Always lowercase 'burden' unless beginning sentence; quantify when possible.
In Context
- "The patient's high anticholinergic burden from multiple medications may be contributing to her cognitive decline." — medication review consultation
- "Reducing anticholinergic burden improved the patient's attention and reduced episodes of confusion." — clinical progress note