Table 1:
Different anticholinergic scales.
| Score name | Princeps publication | Country | Princeps study population | Methods to assess anticholinergic activity | Princeps study main results | Type of anticholinergic adverse effects: central and peripheral | Observations |
|---|---|---|---|---|---|---|---|
| Anticholinergic Cognitive Burden Scale (ACB) | Boustani et al. 2008 [8] | USA | Older adults attending primary care clinics in Indianapolis (n = 3013) | Expert-based list | High level of anticholinergic burden. More than 23% of older adults were receiving at least one medication with anticholinergic activity | Central | One of the most used scale in elderly population |
| Anticholinergic Risk Scale (ARS) | Rudolph et al. 2008 [9] | USA | Older men adults (≥65 years) attending geriatric at the Veterans Affairs Boston Healthcare System or primary care ambulatory clinics (n = 117) | Expert-based list | Higher ARS scores are associated with increased risk of anticholinergic adverse effects | Peripheral and central | One of the most used scale in elderly population |
| Anticholinergic Drug Scale (ADS) | Carnahan et al. 2002 [10] | USA | Older adults from rural long term care facilities (n = 98) | List created using association with the SAA | Significant correlation between SAA and anticholinergic drug scale | Peripheral | One of the most used scale in elderly population |
| - Focused on peripheral ADR | |||||||
| - ADS did not use the clinical input of expert clinicians and did not focus on the cognitive effects of anticholinergics | |||||||
| Clinician-rated Anticholinergic Score (CrAS) | Han et al. 2001 [11] | Canada | Older inpatients (≥65 years) with diagnosed incident or prevalent delirium (n = 278) | Expert-based list | Exposure to anticholinergic medications is independently and specifically associated with a subsequent increase in delirium symptom severity | Central | Limited number of publications using this scale |
| Anticholinergic Impregnation Scale (AIS) | Briet et al. 2017 [12] | France | Psychiatric patients (n = 7278) | Expert-based list | A high anticholinergic burden (AIS score >5) was associated with a higher rate of prescription of two anticholinergic adverse drug reaction correctors: laxatives and drugs against xerostomia | Peripheral | Limited number of publications using this scaleSpecific to psychiatric population and focused on peripheral ADR |
| Anticholinergic Burden Classification (ABC) | Ancelin et al. 2006 [13] | France | Older adults participants (aged >60 years) through 63 randomly selected general practitioners in the Montpellier region of southern France (n = 372) | Expert-based list | Association between high anticholinergic burden and mild cognitive impairment | Central | Limited number of publications using this scale |
| Anticholinergic Activity Scale (AAS) | Ehrt et al. 2010 [14] | Norway | A community-based cohort of patients with Parkinson's disease (n = 235) | Expert-based list | Association between anticholinergic drug use and cognitive decline in Parkinson's disease | Central | Limited number of publications using this scaleSpecific to patients with Parkinson's disease |
| Anticholinergic Effect on Cognition (AEC) | Bishara et al. 2017 [15] | UK | Not applicable. List developed for older patients | Expert-based list | Not applicable | Central | Limited number of publications using this scale |
| Muscarinic Acetylcholine Receptor Antagonist Exposure (MARANTE) | Klamer et al. 2017 [16] | Belgium | Not applicable. List developed for older patients | Expert-based list | Not applicable | Central | Limited number of publications using this scale |
| Anticholinergic Load scale (ACL) | Sittironnarit et al. 2011 [17] | Australia | Older adults participants (aged >60 years): a cohort of 211 Alzheimer's disease patients, 133 mild cognitive impairment patients and 768 healthy controls | Expert-based list | Association between ACL and psychomotor speed and executive function in healthy older adults | Central | Limited number of publications using this scale |
| Anticholinergic Burden (ACB) | Kiesel et al. 2018 [18] | Germany | Not applicableList developed for older patients | Expert-based listBy different scores comparison and adapted to German prescription | Not applicable | Peripheral and central | Limited number of publications using this scaleSpecific to Germany |
| Brazilian Anticholinergic Activity scale (BAA) | Nery et al. 2019 [19] | Brazil | Not applicable. List developed for older patients | Expert-based listBy different scores comparison and adapted to Brazilian prescription | Not applicable | Peripheral and central | Limited number of publications using this scaleSpecific to Brazil |
| Anticholinergic Burden Scale (KABS) | Jun et al. 2019 [20] | South Korea | Not applicable. List developed for older patients | Expert-based listBy different scores comparison and adapted to South Korean prescription | Not applicable | Peripheral and central | Limited number of publications using this scaleSpecific to South KoreaDrug dosages use in this evaluation |