The Anticholinergic Drug Scale as a measure of drug-related anticholinergic burden: associations with serum anticholinergic activity

J Clin Pharmacol. 2006 Dec;46(12):1481-6. doi: 10.1177/0091270006292126.


Anticholinergic Drug Scale (ADS) scores were previously associated with serum anticholinergic activity (SAA) in a pilot study. To replicate these results, the association between ADS scores and SAA was determined using simple linear regression in subjects from a study of delirium in 201 long-term care facility residents who were not included in the pilot study. Simple and multiple linear regression models were then used to determine whether the ADS could be modified to more effectively predict SAA in all 297 subjects. In the replication analysis, ADS scores were significantly associated with SAA (R2 = .0947, P < .0001). In the modification analysis, each model significantly predicted SAA, including ADS scores (R2 = .0741, P < .0001). The modifications examined did not appear useful in optimizing the ADS. This study replicated findings on the association of the ADS with SAA. Future work will determine whether the ADS is clinically useful for preventing anticholinergic adverse effects.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Binding, Competitive
  • Cholinergic Antagonists / blood
  • Cholinergic Antagonists / metabolism
  • Cholinergic Antagonists / therapeutic use*
  • Cross-Sectional Studies
  • Delirium / blood
  • Delirium / drug therapy*
  • Delirium / psychology
  • Female
  • Humans
  • Linear Models
  • Long-Term Care
  • Male
  • Middle Aged
  • Prospective Studies
  • Radioligand Assay
  • Time Factors


  • Cholinergic Antagonists