The use of anticholinergic medications in homebound elderly patients with dementia

Consult Pharm. 2006 May;21(5):391-9. doi: 10.4140/tcp.n.2006.391.


Objective: Identify the number of homebound older adults admitted to a home-based health care agency in 2003 with a diagnosis of dementia. Compare the use of anticholinergic medications in older adults with a diagnosis of dementia to a matched comparison group without a diagnosis of dementia.

Design: Retrospective, cohort study.

Setting: Home health care agency in the eastern part of Washington State serving the homebound.

Participants: Homebound subjects 60 years of age or older with or without a diagnosis of dementia.

Interventions: N/A.

Main outcome measures: Number of homebound subjects with a diagnosis of dementia. Comparison of those in the group diagnosed with dementia (n = 50) to a matched cohort in the group with no dementia diagnosis (n = 50) in regard to use of drugs with anticholinergic activity.

Results: From a population of 1,746 patients served in 2003 who met the study criteria, 107 (6.1%) patients had a diagnosis of dementia. Of these, 50 were studied. Of the subjects with dementia, 62% were prescribed a drug with anticholinergic activity, compared with 80% of subjects without dementia. Fewer patients in the study group were prescribed anticholinergic drugs than in the comparison group. The primary drugs with anticholinergic activity cited most often were olanzapine, hydroxyzine, and mirtazapine.

Conclusion: Drugs with anticholinergic activity are used frequently in an older homebound population, irrespective of a dementia diagnosis.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cholinergic Antagonists* / therapeutic use
  • Cohort Studies
  • Contraindications
  • Dementia / drug therapy*
  • Drug Utilization
  • Female
  • Home Care Agencies
  • Homebound Persons*
  • Humans
  • Male
  • Middle Aged
  • Practice Patterns, Physicians'


  • Cholinergic Antagonists