Clinical Significance of Anticholinergic Burden (ACB) Scores in Dementia

To improve patient care by identifying:• Whether anticholinergic burden

scores are directly linked to impaired cognition, falls, confusion, delirium, dizziness, and hospitalisations in patients suffering from dementia.

• Whether there are any other possible factors contributing to these symptoms.

• Whether reducing the anticholinergic burden score has a direct effect on these symptoms and on patient wellbeing.

Aims

Dr Lubecca Mahmood (FY1) & Dr Faria Zafar (Consultant Old Age Psychiatrist)

• Many patients living with dementia are prescribed medicines with a high anticholinergic burden (ACB).

• This term refers to the cumulative effect of using multiple medications with anticholinergic burden properties simultaneously.

• ACB in older adults has been correlated with impaired cognition, falls, confusion, delirium, dizziness and hospitalisations.

• It is unclear as to whether high ACB scores are directly related to these presentations, or whether there are other factors contributing.

Background

• A retrospective audit • Audit sample: Patients with a known

dementia diagnosis, and associated physical and/or mental health co-morbidities

• Number of patients: 23• Data collection time period: 9th

December 2020 – 10th January 2021

Methods

Clinical Presentation vs ACB Score

ACB Scores Following Reviews

• No clear correlation between high ACB scores and impaired cognition, falls, confusion, delirium, dizziness, and hospitalisations in dementia patients.

• Possibility of other contributory factors affecting their clinical presentation.

• Insufficient evidence to suggest that reducing the anticholinergic burden leads to an improved outcome.

Conclusions

Recommendations

Findings

Acknowledgements:Denise Parr (Dementia Outreach Nurse), Kate Lukoschek (Community Psychiatric

Nurse), and the CWP NHS Trust Audit Department

Contact:lubecca.mahmood@nhs.net

Audit Standards