Drugs with anticholinergic effects have adverse effects affecting both central and peripheral nervous systems because of the wide distribution of muscarinic acetylcholine receptors in the body. These adverse effects may include cognitive impairment, falls and all-cause mortality, according to a systematic review and meta-analysis published in the British Journal of Clinical Pharmacology
The analysis included 18 studies with a total of 124,286 participants. Use of any drug with anticholinergic effects was associated with a 45% increased risk of cognitive impairment while each 1-unit increase in the anticholinergic cognitive burden scale was associated with a doubling in the odds of all-cause mortality. Also, exposure to olanzapine or trazodone was associated with an increased risk of falls.
“Our findings raise concerns about the risks of prescribing of drugs with anticholinergic effects,” say the authors.
 Ruxton K, Woodman RJ & Mangoni AA. Drugs with anticholinergic effects and cognitive impairment, falls and all-cause mortality in older adults: a systematic review and meta-analysis. Br J Clin Pharmacol 2015. doi:10.1111/bcp.12617.