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Serum Anticholinergic Activity and Cognitive and Functional Adverse Outcomes in Older People: A Systematic Review and Meta-Analysis of the Literature


Salahudeen, MS and Chyou, T-Y and Nishtala, PS, Serum Anticholinergic Activity and Cognitive and Functional Adverse Outcomes in Older People: A Systematic Review and Meta-Analysis of the Literature, PloS one, 11, (3) ISSN 1932-6203 (2016) [Refereed Article]


Copyright Statement

Copyright 2016 Salahudeen et al. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

DOI: doi:10.1371/journal.pone.0151084


Introduction: Studies have reported associations between serum anticholinergic activity (SAA) and decline in cognitive performance, delirium, and functional impairment. The aim of this metaanalysis was to explore and quantify associations between SAA and adverse cognitive and functional outcomes in older people.

Materials and Methods: A literature search in Ovid MEDLINE, EMBASE, PsycINFO and IPA from 19462014 was completed. The primary outcomes of interest were cognitive and functional adverse outcomes associated with SAA in older people aged 55 years and above. The Cochrane RiskBias assessment tool was used to assess bias in randomised controlled trials (RCTs). The Newcastle-Ottawa Scale was used to assess the quality of non-RCTs. Meta-analyses were conducted for RCTs and cohort studies separately. Heterogeneity was assessed using I 2 tests.

Results: The primary electronic literature search identified a total of 1559 records in the 4 different databases. On the basis of full-text analysis, 33 studies that met the inclusion criteria. The review included 4 RCTs, 5 prospective cohort studies, 3 longitudinal cohort studies, 17 cross-sectional studies, and 4 case-control studies. Twenty-four of the retrieved studies examined an association between SAA and cognitive outcomes, 2 studies examined an association with SAA and functional outcomes and 8 studies examined associations between SAA and both cognitive, and functional outcomes. The meta-analysis on 4 RCTs showed no association with higher SAA and cognitive performance (I 2 = 89.38%, H2 = 25.53 and p-value = <0.05) however, the pooled data from 4 observational studies showed elevated SAA was associated with reduced cognitive performance (I 2 = 0.00%, H2 = 3.37 and p-value = 0.34).

Item Details

Item Type:Refereed Article
Keywords:Serum Anticholinergic Activity; Cognitive; Functional; Adverse Outcomes; Older People; SAA
Research Division:Biomedical and Clinical Sciences
Research Group:Pharmacology and pharmaceutical sciences
Research Field:Clinical pharmacy and pharmacy practice
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health outcomes
UTAS Author:Salahudeen, MS (Dr Mohammed Salahudeen)
ID Code:125370
Year Published:2016
Web of Science® Times Cited:26
Deposited By:Pharmacy
Deposited On:2018-04-15
Last Modified:2018-06-07
Downloads:77 View Download Statistics

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