Prevalence of Anticholinergic Burden Related to Medication used by the Elderly: A Crosssectional Retrospective Analysis

Abstract

Introduction: According to IBGE (2022), the total number of people over 60 years old reached 15.6%, making Brazil
the world’s fourth-largest pharmaceutical consumer market. In this context of polypharmacy, one of the concerns
is the anticholinergic burden, which refers to the accumulation of intrinsic anticholinergic activity in various drugs.
The analysis of the prevalence and frequency of anticholinergic burden provides relevant data, as several adverse
effects are attributed to the accumulation of these substances in the body. Objective: To identify the prevalence
of use and the anticholinergic burden of medications used by the elderly. Method: A retrospective cross-sectional
observational study with an analysis of electronic medical records from a geriatric outpatient clinic, aiming to determine the prevalence of anticholinergic drug use in the elderly, as well as to calculate the anticholinergic burden
using the Anticholinergic Risk Scale (ARS) and the Brazilian Anticholinergic Scale (BAS). Results: EBA identified 69%
of patients as users of medications with an anticholinergic burden, whereas the ARS scale indicated only 38%. The
high anticholinergic risk was also higher according to BAS’s assessment: 28%, compared to 7.6% according to ARS.
Conclusion: A high frequency of anticholinergic medication use among the elderly was confirmed, especially considering BAS. This finding is alarming, as anticholinergic burden has central and peripheral effects and is associated
with unfavorable clinical outcomes, including cognitive and functional impairment, falls, hospitalization, and death.
Implementing preventive strategies at primary healthcare levels is essential to mitigate the risks of iatrogenesis, including the investigation of specific data and the validation of tools to calculate the anticholinergic burden of medications used in Brazil.