Home › Research › Risk factors
Use of medications with anticholinergic effect predicts clinical severity of delirium symptoms in older medical inpatients
Han L, McCusker J, Cole M, Abrahamowicz M, Primeau F, Elie M.. Archives of internal medicine, 2001-04-01
Topic: Risk, prevention and care in population studies
Background Use of anticholinergic (ACH) medications is a biologically plausible and potentially modifiable risk factor of delirium, but research findings are conflicting regarding its association with delirium. Objectives To evaluate the longitudinal association between use of ACH medications and severity of delirium symptoms and to determine whether this association is modified by the presence of dementia. Patients and methods A total of 278 medical inpatients 65 years and older with diagnosed incident or prevalent delirium were followed up with repeated assessments using the Delirium Index for up to 3 weeks. Exposure to ACH and other medications was measured daily. The association between change in medication exposure in the 24 hours preceding a Delirium Index assessment was assessed using a mixed linear regression model. Results During follow-up (mean +/- SD, 12.3 +/- 7.0 days), 47 medications with potential ACH effect were used in the population (mean, 1.4 medications per patient per day). Increase in delirium severity was significantly associated with several measures of ACH medication exposure on the previous day, adjusting for dementia, baseline delirium severity, length of follow-up, and number of non-ACH medications taken. Dementia did not modify the association between ACH medication use and delirium severity. Conclusion Exposure to ACH medications is independently and specifically associated with a subsequent increase in delirium symptom severity in elderly medical inpatients with diagnosed delirium.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Han, L., McCusker, J., Cole, M., Abrahamowicz, M., Primeau, F., & Elie, M. (2001). Use of medications with anticholinergic effect predicts clinical severity of delirium symptoms in older medical inpatients. Archives of internal medicine. https://doi.org/10.1001/archinte.161.8.1099
Vancouver
Han L, McCusker J, Cole M, Abrahamowicz M, Primeau F, Elie M. Use of medications with anticholinergic effect predicts clinical severity of delirium symptoms in older medical inpatients. Archives of internal medicine. 2001. doi:10.1001/archinte.161.8.1099. PMID: 11322844.
BibTeX
@article{han2001-11322844,
author = {Han, L. and McCusker, J. and Cole, M. and Abrahamowicz, M. and Primeau, F. and Elie, M.},
title = {{Use of medications with anticholinergic effect predicts clinical severity of delirium symptoms in older medical inpatients}},
journal = {Archives of internal medicine},
year = {2001},
doi = {10.1001/archinte.161.8.1099},
pmid = {11322844},
url = {https://doi.org/10.1001/archinte.161.8.1099}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- Results During follow-up (mean +/- SD, 12.3 +/- 7.0 days), 47 medications with potential ACH effect were used in the population (mean, 1.4 medications per patient per day).
- Increase in delirium severity was significantly associated with several measures of ACH medication exposure on the previous day, adjusting for dementia, baseline delirium severity, length of follow-up, and number of non-ACH medications taken.
- Conclusion Exposure to ACH medications is independently and specifically associated with a subsequent increase in delirium symptom severity in elderly medical inpatients with diagnosed delirium.
Why it matters
In older medical inpatients with delirium, increased exposure to anticholinergic medications was associated with greater delirium severity, and dementia did not change this association. This concerns delirium severity, not treating, curing, or preventing Alzheimer's disease.
New to this subject? Start with our plain-English guide: Risk factors, ranked →
Study details
- Study designlongitudinal study
- Participants278
- Evidence strengthModerate
How this study scored 55/100
Published in a peer-reviewed journal, and it is a longitudinal study following the same people over time. Scored zero for effect reported and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 53 of the 96 points we could judge it on, which is 55 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Archives of internal medicine) |
| Journal's citation record | 3 / 4 | Archives of Internal Medicine: journal h-index 462 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2001 — older than 20 years, still counted |
| Sample size | 2 / 4 | 278 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 446 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 16.5 citations a year over 27 year(s) since 2001 |
| Impact for its field and year | 3 / 6 | Cited 6.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 2 other studies in this library |
| Still being cited | 2 / 4 | Cited 33 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author Michel Élie holds only 8 work(s), too few to judge a track record — left out of this score |
| Institution's track record | 0 / 3 | St Mary's Hospital Centre: institution h-index 141 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 11322844) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 53 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 53 of the 96 points we could judge it on is 55 out of 100. |
| Total | 55 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
May need a subscription OpenAlex found no free copy of the full text (checked 6 Feb 1020), so the publisher may charge for it. The PubMed abstract is free.
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.
Later studies that cite this one
2 studies in the alzhub library list this one in their references.
Related studies in Risk factors
Also tagged “palliative”
858 studies in the library carry the topic tag “palliative”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 858 tagged studies.