Fox 2011a.

Study characteristics
Methods	Design: retrospective cohort Setting: community Country: UK Duration of follow‐up: 2 years Covariates controlled for: age, sex, baseline MMSE, education, social class, number of non‐anticholinergic medications, and number of comorbidities
Participants	Participants numbers: 12,423 Population type: older adults Sex: 60% women (7417) Age (mean): not stated
Prognostic factors	Anticholinergic burden measurement method: ACB scale
Outcomes	Outcomes assessed: cognitive decline Outcome ascertainment cognitive decline: MMSE Diagnostic criteria for cognitive decline: scores on cognitive testing
Source of funding	Medical Research Council, UK
Notes
Item	Authors' judgement	Support for judgement
Study participation	Unclear	Lack of detail in reporting exclusion criteria. Did not state numbers with baseline dementia.
Study attrition	No	No analysis of missing data. High % of attrition (only 64% remaining at 2‐year follow‐up).
Prognostic factor measurement	Yes	Used self‐report cross‐checked by counting remaining medications. Recorded dosage, frequency, and quantity.
Outcome measurement	Unclear	No blinding to outcome but anticholinergic burden likely established after cognitive assessment.
Study confounding	Unclear	Age, sex, and comorbidities all measured (comorbidities included both physical and psychiatric). However, controls for 'number of health conditions' rather than each condition individually.
Reverse causation	Unclear	Restricted analysis to anticholinergic burden baseline association with change in MMSE score at 2 years.
Statistical analysis and reporting	Unclear	No assumptions checked or protocol registered.