medicines with anti-cholinergic properties have a significant adverse effect on cognitive and physical function , but limited evidence exists for delirium or mortality outcomes
OBJECTIVES to determine the effect of drugs with anti-cholinergic properties on relevant health outcomes .
Delirium in acute stroke: a preliminary study of the role of anticholinergic medications
The pathogenesis of delirium in acute stroke is incompletely understood . The use of medications with anticholinergic ( ACH ) activity is associated with an increased frequency of delirium . We hypothesized that the intake of medications with ACH activity is associated with delirium in acute stroke patients . Delirium was assessed using the DSM‐IV‐TR criteria and the Delirium Rating Scale , in a sample of consecutive patients with an acute ( ≤4 days ) cerebral infa rct or intracerebral haemorrhage ( ICH ) . We performed a gender and age matched case – control study . Twenty‐two delirious stroke patients ( cases ) and 52 non‐delirious patients ( controls ) were compared concerning the intake of  ACH medications ( i ) before stroke , ( ii ) during hospitalization but before the assessment . The variables associated with delirium on bivariate analysis were entered in a stepwise logistic regression analysis . The final regression model ( Nagelkerke R2 = 0.65 ) retained  non‐neuroleptics ACH medication during hospitalization ( OR = 24.4 ; 95 % CI = 2.18–250 ) , medical complications ( OR = 20.8 ; 95 % CI = 3.46–125 ) , ACH medication taken before stroke ( OR = 17.5 ; 95 % CI = 1.00–333.3 ) and ICH ( OR = 16.9 ; 95 % CI = 2.73–100 ) as independent predictors of delirium . This preliminary result indicates that drugs with subtle ACH activity play a role in the pathogeneses of delirium in acute stroke . Medication with ACH activity should be avoided in acute stroke patients
medicines with anti-cholinergic properties have a significant adverse effect on cognitive and physical function , but limited evidence exists for delirium or mortality outcomes
OBJECTIVES to determine the effect of drugs with anti-cholinergic properties on relevant health outcomes .