A pilot project to assess the association of anticholinergic symptoms with anticholinergic serum levels in the elderly.

STUDY OBJECTIVE

To evaluate whether serum anticholinergic drug activity would be a useful clinical tool in helping to predict anticholinergic toxicity.

DESIGN

A prospective study that included a retrospective chart review.

SETTING

Two nursing home facilities.

SUBJECTS

Thirty-one elderly volunteers between ages 69 and 98 years.

INTERVENTION

Each subject completed a two-part interview. First, anticholinergic symptoms were evaluated and then cognitive function was assessed by three neuropsychiatric tests. Blood (10 ml) was collected to measure anticholinergic activity.

MEASUREMENTS AND MAIN RESULTS

Eight subjects had detectable serum anticholinergic activity and scored higher on the Symbol Digit Modalities test than those with no detectable activity. No statistical difference was seen between the groups with respect to symptoms or results of the Mini-Mental and Auditory-Verbal Learning tests.

CONCLUSION

The clinical usefulness of serum anticholinergic activity as a predictor for anticholinergic toxicity was not established under the experimental design of this study.