Anticholinergic Cognitive Burden Scale

The Anticholinergic Cognitive Burden Scale is a measure of the total impact of drugs with anticholinergic activity on cognition.

Caveats:

(1) drugs with in vitro activity may not cross the blood brain barrier

(2) receipt of multiple drugs with anticholinergic activity has an additive effect on cognition

(3) different anticholinergic burden scales may place a drug into different categories

Parameters:

(1) number of drugs with level 1 effect

(2) number of drugs with level 2 effect

(3) number of drugs with level 3 effect

anticholinergic cognitive burden scale =

= (number of level 1 drugs) + (2 * (number of level 2 drugs)) + (3 * (number of level 3 drugs)

Interpretation:

• minimum score: 0

• maximum score: over 20

Scoring:

(1) level 1: based on in vitro evidence of antagonist activity at muscarinic receptor

(2) level 2: clinical anticholinergic effect

(3) level 3: can cause delirium

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