Anticholinergic Medication and Our Aging Population

A friend sent me a study which was reviewing the side effects of anticholinergic medication in older Americans.  [for a list of medications that contain anticholinergic properties, please follow this link.  You may wish to review this list, particularly if you are taking any medications].

The study cites that

“patients older than 65 years are prescribed a mean of 6 medications [emphasis added].  Age related pharmacokinetic and pharmacodynamic changes increase the risk of adverse effects and interactions.”

Further, according to this study,  there are

“medications  that are considered inappropriate in adults older than 65 years. “


“12 to 21% of older patients in the United States use such agents.”

The study further expounds that

“medications with Anticholinergic properties have frequently been cited in the literature as causing an increase in adverse events.  Such conditions often lead to consequences such as falls, impulsive behavior and loss of independence.  Higher rates of cognitive dysfunction and delirium are found in patients experiencing a greater Anticholinergic load.

“The study created an Anticholinergic Risk Scale (ARS) specifically to review cognitive dysfunction and delirium. The objective of this study was to determine if the ARS score could be used to predict the risk of anticholinergic adverse effects in a geriatric evaluation and management (GEM) cohort and in a primary care cohort.”

In other words, would prospective older primary care population patients taking medication with anticholinergic properties who experienced similar side effects potentially experience the increased adverse effects of multiple use or cumulative amounts of anticholinergic remnants in their system that their older counterparts do, i.e. cogtnitive impairement, delirium.

They found a direct correlation between increased adverse effects and increase in age and, potentially, use of more agents containing Anticholinergic properties.

I have written about this before but I find that  the topic is so important because we have become a country of drug users.  Our doctors have become the pushers and the pharmaceuticals are the source.  The above study claims that the mean number of pharmaceuticals taken by the average 65 year old is six.  Most of these pills have side effects.  combine them and the side effects increase exponentially.

I write about this because these statistics are frightening to me.  I write about this because, knock on wood, God willing and the Creek don’t rise, I do not take any pharmaceuticals.  In fact, one day a couple of years ago, I was at the eye doctor.  The intake nurse asked me my age.  Her second question: “What medications are you taking?”  I replied, “None.”  Her head shot up and she looked at me.  She replied, “None?”  I said, “None. Is that unusual?”  She replied, “You are the first person who has ever given me that answer.”  !!! Wow! I guess it is unusual.


© Yvonne Behrens, M.Ed  2012

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