ANTICHOLINERGIC BURDEN OF DRUGS PRESCRIBED TO GERIATRIC PATIENTS ATTENDING MEDICINE OUTPATIENT DEPARTMENT

Background: Anticholinergic effects of drugs, particularly those prescribed to geriatric patients, have garnered significant attention due to their potential to induce a range of adverse outcomes, including cognitive decline, urinary retention, and increased risk of falls. Anticholinergic medications function by blocking the action of acetylcholine, neurotransmitter crucial for numerous involuntary bodily functions, and their use is prevalent in treating conditions – depression, anxiety & respiratory disorders among older adults. The clinical implications of these medications are profound, as older individuals often possess heightened vulnerability to their side effects, exacerbated by polypharmacy, age-related physiological changes. Evidence increasingly suggests, long-term use of these may lead to increased anticholinergic burden, associated with severe cognitive impairment and potentially contributing to the development of dementia. Objectives: Assess the anticholinergic burden in geriatric patients attending the medicine OPD. Methods: An observational, cross-sectional study was conducted during the period of mid-September to mid-November 2024, after approval from IEC(H) of the institute. Prescriptions of all geriatric patients above 60 years assessed after taking consent from prescribing physicians in MOPD. Drugs having anticholinergic properties will be scored by Anticholinergic Cognitive Burden Scale. After collection of data, they were entered & analysed using MS Excel 19. Results: Clinically significant anticholinergic burden was observed in 43.125% population. The most frequently prescribed drug was found to be Domperidone followed by Metformin and Nortriptyline. Among the comorbidities diabetes was commonly seen in majority the population. Conclusion: Co-professional care at MOPD with assessment of anticholinergic burden of geriatric prescriptions and advices on rational de-prescribing with suggestions on safer alternatives would be beneficial for treating physicians to optimize therapy.