Cognitive Effects of Reducing Anticholinergic Drug Burden in a Frail Elderly Population: A Randomized Controlled Trial

COMPLETEDStarted: 1 January 2008Ended: 31 December 2009

Project lead

Hege Kersten

hege.kersten@medisin.uio.no

Location

Norway

Health Boards/Trusts

Other

Project timeline

Start: 1 January 2008

End: 31 December 2009

Submitted: 19 December 2025

Project Description

A randomized, controlled, single-blinded trial conducted in 22 nursing homes in Norway. Long-term residents with an ADS score ≥3 were randomly allocated to intervention or control. The intervention involved pharmacist-led multidisciplinary drug reviews to reduce ADS score. Cognitive function was assessed using immediate recall, Mini-Mental State Examination, delayed recall, recognition of words, saliva flow, and serum anticholinergic activity. Participants were retested after 4 and 8 weeks.

Project Aim/Purpose

To investigate whether a pharmacist-initiated reduction of anticholinergic drug scale (ADS) score improves cognitive function in a frail elderly population.

Intervention

Pharmacist-initiated multidisciplinary drug reviews aimed at reducing anticholinergic drug burden.

Intervention Delivered By

Clinical pharmacist

Patient/Participant Inclusion

Long-term nursing home residents with ADS score ≥3, excluding those with blindness, deafness, aphasia, delirium, or severe dementia.

Outcomes Measured

Immediate recall, Mini-Mental State Examination, delayed recall, recognition of words, saliva flow, serum anticholinergic activity.

Evaluation

Achievements & Outcomes

Achieved significant reduction in ADS score but no significant improvement in cognitive function or peripheral anticholinergic symptoms.

What Went Well

Successful implementation of pharmacist-led drug reviews and reduction in anticholinergic drug burden.

What Went Less Well

No significant improvement in cognitive outcomes despite reduced ADS score.