Anticholinergics and falls in older adults
Document Type
Article
Publication Date
3-1-2022
Abstract
Introduction The use of medications with anticholinergic (ACh) properties is associated with numerous adverse effects especially in older adults. Emerging evidence suggests the presence of long-term effects with ACh use. Areas covered Our article presents an overview of ACh effects and falls in older individuals including examination of emerging evidence on ACh use and cumulative exposure on short-term and long-term falls risk. The databases CINAHL, MEDLINE, EMBASE, and Web of Science were searched for articles published from January 2002 to December 2021. Expert opinion Anticholinergic side effects include muscle weakness, blurred vision, and mental confusion which are likely to lead to increased falls risk. Many commonly used medications such as beta-blockers, calcium-channel blockers, and antihistamines are now known to have mild ACh properties. With polypharmacy now considered unavoidable in older patients, the cumulative effects of the use of multiple drugs with mild ACh properties may also lead to increased falls risk. The relationship between ACh drugs and falls may also be irreversible as ACh effects may extend beyond the period of drug use, due to cognitive and physical deconditioning following the initial exposure to ACh drugs. Future long-term studies with accurate quantification of cumulative ACh exposure and measurement of actual falls outcomes are urgently required.
Keywords
Anticholinergic syndrome, Accidental falls, Aged, Polypharmacy, Drug-related side effects and adverse reactions
Divisions
medicinedept
Funders
Ministry of Higher Education Long-Term Research Grant Scheme (LRGS/1/2019/UM/01/1/1)
Publication Title
Expert Review of Clinical Pharmacology
Volume
15
Issue
3
Publisher
Taylor & Francis Ltd
Publisher Location
2-4 PARK SQUARE, MILTON PARK, ABINGDON OR14 4RN, OXON, ENGLAND