Anticholinergic Drug Burden and Delirium: A Systematic Review

ObjectivesTo investigate the association between anticholinergic drug burden (ADB), measured with scales, and delirium severity.DesignSystematic review.Setting ParticipantsAll available studies.MethodsA systematic literature search was performed in Medline, Embase, PsycINFO, Web of Science, CINAHL, Cochrane library, Google Scholar. Studies evaluating ADB (measured as a total score) or severity, published English, were eligible for inclusion.ResultsSixteen studies, including 148,756 persons, included. Fifteen studies investigated delirium. Anticholinergic Risk Scale (ARS, n = 5), Cognitive Burden (ACB, 6), list Chew (n 1), Drug (ADS, modified version ARS ACB 1). A high ADB, ARS, associated (5/5). Also ACB, an found during 3-month (1/1) 1-year follow-up (1/1), respectively. When assessed other results inconclusive, only 1 positive (1/6) ADS (1/5) each. The possible severity has also been (ADS 2, Summers Number One study ADS, increase delirium.Conclusions ImplicationsADB is consistently versions needs confirmation. findings inconclusive. current suggest that might be useful tool to identify patients at increased risk