{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T11:20:16Z","timestamp":1790162416258,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,2,5]],"date-time":"2013-02-05T00:00:00Z","timestamp":1360022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>This study evaluated a presumed gradual decline in cognitive function in nursing home residents when the anticholinergic drug scale (<jats:styled-content style=\"fixed-case\">ADS<\/jats:styled-content>) score increased above 3.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The study population was recruited from 21 nursing homes in <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>orway. Criteria for inclusion were <jats:styled-content style=\"fixed-case\">ADS<\/jats:styled-content> score\u2009\u2265\u20093 and no severe dementia, defined as Clinical Dementia Rating (<jats:styled-content style=\"fixed-case\">CDR<\/jats:styled-content>) score &lt; 3. Primary cognitive end points were <jats:styled-content style=\"fixed-case\">CERAD<\/jats:styled-content> 10\u2010word lists for recall and Mini Mental State Examination (<jats:styled-content style=\"fixed-case\">MMSE<\/jats:styled-content>). Secondary end points were activity of daily living (<jats:styled-content style=\"fixed-case\">ADL<\/jats:styled-content>), mouth dryness and serum anticholinergic activity (<jats:styled-content style=\"fixed-case\">SAA<\/jats:styled-content>). The patients were stratified into subgroups according to <jats:styled-content style=\"fixed-case\">ADS<\/jats:styled-content> score, i.e. a reference group with score 3 and test groups with scores 4, 5 or \u22656. End points were compared by analyses of covariance (<jats:sc>ancova<\/jats:sc>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 230 of the 1101 screened nursing home residents (21%) had an <jats:styled-content style=\"fixed-case\">ADS<\/jats:styled-content> score \u22653. After exclusion 101 residents were recruited and among these, 87 managed to participate in the study. No significant differences were detected in cognitive function or <jats:styled-content style=\"fixed-case\">ADL<\/jats:styled-content> when <jats:styled-content style=\"fixed-case\">ADS<\/jats:styled-content> increased above 3 (<jats:italic>P<\/jats:italic> &gt; 0.10), but <jats:italic>in vivo<\/jats:italic> (mouth dryness) and <jats:italic>in vitro<\/jats:italic> (<jats:styled-content style=\"fixed-case\">SAA<\/jats:styled-content>) measures of peripheral anticholinergic activity were significantly higher in patients with an <jats:styled-content style=\"fixed-case\">ADS<\/jats:styled-content> score \u22656 (<jats:italic>P<\/jats:italic> &lt; 0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The present study does not support a progressive decline in cognitive function with <jats:styled-content style=\"fixed-case\">ADS<\/jats:styled-content> score above 3. This might indicate that the <jats:styled-content style=\"fixed-case\">ADS<\/jats:styled-content> score model has limited potential to predict the clinical risk of central anticholinergic side effects in frail elderly patients receiving multiple anticholinergic drugs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1365-2125.2012.04411.x","type":"journal-article","created":{"date-parts":[[2012,8,27]],"date-time":"2012-08-27T19:24:32Z","timestamp":1346095472000},"page":"842-849","source":"Crossref","is-referenced-by-count":49,"title":["Higher anticholinergic drug scale (<scp>ADS<\/scp>) scores are associated with peripheral but not cognitive markers of cholinergic blockade. 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