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Researchers have developed a new tool to help doctors and pharmacists identify older patients at risk of delirium and serious falls associated with taking multiple anticholinergic medications.

Anticholinergic medications are widely used to treat a range of conditions. However, there are many medications that have anticholinergic effects even when this is not their main purpose. Taking multiple medications with these effects, known as anticholinergic burden, can increase the risk of delirium, falls and dementia—particularly in older people.

In research published in BMJ Medicine, researchers at the University of Leeds, University of Liverpool and Bradford Institute for Health Research have developed the Anticholinergic Medication Index (ACMI) to score a patient's anticholinergic burden, based on the risk of delirium or falls.

Researchers designed the ACMI to be embedded into electronic patient record systems, enabling health care professionals to efficiently prioritize patients with a high score to optimize their medicines.

First author Dr. Kate Best, associate professor of applied statistics at the University of Leeds, said, "Approximately 50% of older adults are prescribed at least one anticholinergic medication annually in the U.K. While an anticholinergic medication might sometimes be the best treatment, with so many drugs that have this unintended side effect, anticholinergic burden can easily accumulate and pose a significant risk.

"Falls and delirium can be devastating for the health and well-being of older people, with considerable cost to the NHS.

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