This systematic review suggests that the risk of fractures is increased in persons with high anticholinergic burden.

In studies using Anticholinergic Risk Scale (ARS), the risk increases with increasing anticholinergic burden, suggesting a dose exposure gradient.

We found that one study reported an increased risk of lower BMD at Ward’s triangle in persons with high anticholinergic burden, however a second study did not find an association.

Overall, the studies used heterogeneous methods and few studies had high quality. This calls for conduct of more high quality studies.