Impact of anticholinergic burden on cognitive impairment, disability and malnutrition: a cross-sectional study among hospitalized older patients

The anticholinergic burden (ACB) is known to be associated with the worsening of functional and cognitive status. This study aims at demonstrating a correlation between the ACB and the malnutrition, given the widespread effect on the digestive tract of anticholinergic medications. From 2012 to 2018, 2843 patients were recruited among the new admissions to our Geriatric Unit. For each patient the activities of daily living (ADL), the instrumental activities of daily living (IADL), the mini mental state examination (MMSE), the cumulative illness rating scale (CIRS), the mini nutritional assessment (MNA) and the ACB of medications were evaluated. The correlations between the ACB and the ADL (P<0.001), the IADL (P<0.001), the MMSE (P<0.001) scores were confirmed, and a significant correlation was also found between the ACB and the MNA (P<0.001) score. The CIRS and the ACB scores resulted to be independent predictors of all outcomes considered, in a linear regression model adjusted for age, sex, comorbidity and number of prescribed drugs. Therefore, ACB seems to have by itself an impact on physical and cognitive functions and on nutritional status.