Anticholinergic Burden Assessment Tool

A tool for finding the ACB Score of commonly prescribed medicines, and for calculating the Anticholinergic Burden for your patient.

Anticholinergic Burden Assessment Tool

A tool for finding the ACB Score of commonly prescribed medicines, and for calculating the Anticholinergic Burden for your patient.

Anticholinergic Burden Assessment Tool

A tool for finding the ACB Score of commonly prescribed medicines, and for calculating the Anticholinergic Burden for your patient.

Anticholinergic Burden Assessment Tool

A tool for finding the ACB Score of commonly prescribed medicines, and for calculating the Anticholinergic Burden for your patient.

1.Answer these 8 questions to receive the ACB Score and potential alternatives.
2.Is your patient on any of the following antihistamines?
3.Is your patient on any of the following cardiac agents?
4.Is your patient on any of the following CNS agents, including
Antidepressants, antipsychotics, benzodiazepine
5.Is your patient on any of the following CNS agents, including
Anticonvulsants, anti-parkinsons, opioids
6.Is your patient on any of the following gastrointestinal agents?
7.Is your patient on any of the following musculoskeletal agents?
8.Is your patient on any of the following overactive bladder medications?
9.Is your patient on any of the following agents?
Created by on 25/03/2016

By using this site you acknowledge that you have read, understand, and agree to be bound by our terms of use and privacy policy. All content and tools are for educational use only, are not meant to be a substitute for professional advice and should not be used for medical diagnosis and/or medical treatment.

About this Calculator

Drugs with possible anticholinergic effects are given a score of 1. Drugs with established and clinically relevant cognitive anticholinergic effects are given a score of either 2 or 3, based on the drug blood-brain barrier permeability and its association with the development of delirium. [1-3]

Exposure to medications with anticholinergic effects are associated with reduced physical and cognitive function [4]. Anticholinergic burden is dose-related and cumulative across drugs from different classes. Use of medications with definite anticholinergic effects was associated with a 0.33-point greater decline in MMSE score than not taking anticholinergics [5]. Each one point increase in the ACB total score has been correlated with a 26% increase in the risk of death [5].

Consider risks and benefits of continuous use of specific medications, and consider alternatives if:

  • Patient receiving a medication that has an ACB score of 2 or 3.
  • Total ACB score is 3 or more.

References

Boustani, M., Campbell, N., Munger, S., Maidment, I., & Fox, C.

Impact of anticholinergics on the aging brain: A review and practical application.

Aging Health, 4 (3): 311-320

Campbell, NL, Maidment, I, Fox, C, Khan, B & Boustani, M.

The 2012 update to the anticholinergic cognitive burden scale.

Journal of the American Geriatrics Society, 61 (S1): S142-S143

Campbell, NL., Maidment, I., Fox, C., Khan, B., & Boustani, M.

The 2012 update to the anticholinergic cognitive burden scale.

Journal of American Geriatrics Society, 61(S1), S142-S143. [C46]. https://doi.org/10.1111/jgs.2013.61.issue-s1

Kouladjian L, Gnjidic D, Chen TF, Mangoni AA, Hilmer SN.

Drug Burden Index in older adults: theoretical and practical issues.

Clinical Interventions in Aging 2014, 9: 1503-15

Fox, C. , Richardson, K. , Maidment, I. D., Savva, G. M., Matthews, F. E., Smithard, D. , Coulton, S. , Katona, C. , Boustani, M. A. and Brayne, C.

Anticholinergic Medication Use and Cognitive Impairment in the Older Population: The Medical Research Council Cognitive Function and Ageing Study.

Journal of the American Geriatrics Society 2011, 59 (8): 1477-83

The Anticholinergic Burden Assessment Tool calculator is created by QxMD.

1. Answer these 8 questions to receive the ACB Score and potential alternatives.

Created by on 25/03/2016

By using this site you acknowledge that you have read, understand, and agree to be bound by our terms of use and privacy policy. All content and tools are for educational use only, are not meant to be a substitute for professional advice and should not be used for medical diagnosis and/or medical treatment.

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