Impact of anticholinergics on the aging brain: A review and practical application

Malaz Boustani*, Noll Campbell, Stephanie Munger, Ian Maidment, Chris Fox

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Objective: in an effort to enhance medication prescribing for older adults and reduce the burden of cognitive impairment, this paper reviews the literature regarding the negative impact of anticholinergics on cognitive function and provides clinicians with a practical guidance for anticholinergic use in older adults. Methods: a Medline search identified studies evaluating the use of anticholinergics and the relationship between anticholinergics and cognitive impairment. Results: prescribing anticholinergics for older adults leads to acute cognitive impairment and, possibly, chronic cognitive deficits. Assessing anticholinergic burden with a simple scale may represent a useful noninvasive tool to optimize geriatric pharmacotherapy. Conclusion: more studies are needed to validate the Anticholinergic Cognitive Burden scale and establish therapeutic guidelines in the presence of cognitive anticholinergic adverse effects.

Original languageEnglish
Pages (from-to)311-320
Number of pages10
JournalAging Health
Issue number3
Publication statusPublished - 1 Jun 2008


  • Anticholinergic activity
  • Cognitive impairment
  • Delirium
  • Dementia
  • Elderly
  • Prescribing


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