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:[email protected]
Audit Standards