Medichec

THE ANTICHOLINERGIC EFFECT ON COGNITION TOOL

Medications with anticholinergic effects are known to increase the risk of cognitive impairment, dementia and early death in older adults.
Anticholinergic drugs have a cumulative effect on cognition.
The Anticholinergic Effect on Cognition (AEC) scale aims to help clinicians to identify which drugs have an anticholinergic effect on cognition and defines the extent of this effect.
The AEC scale takes into account the anticholininergic effect of a drug, the extent of this effect, whether it is able to penetrate the brain or not and whether there are in fact reports of cognitive impairment with the drug to support the score given.

Note: This scale scores drugs according to anticholinergic safety only

Medications are categorised according to their anticholinergic score as follows:

Review and withdraw or switch

Caution required

Safe to use

Limited data - unable to scope

Consider reviewing all individual drugs with an AEC score of 2 or above to see whether they can either be withdrawn or switched to a drug with a lower AEC score (preferably 0).
The individual AEC scores of drugs are added together for each patient so as to calculate the total AEC score.
Consider carrying out a medication review for all patients with a total AEC score of 3 or above to see whether the total AEC score can be reduced to the minimum possible.

Note that drug dosage is not taken into account when using this scale.

Do not make any changes to your medication without discussion with your treating physician.

DISCLAIMER

The contents of this work are intended as a guide to enhance the safety of prescribing in people with cognitive impairment.

The contents are not intended and should not be relied upon as recommending or promoting a specific treatment by health science practitioners for any particular patient.

The publisher and authors make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties including without limitation any implied warranties of fitness for a particular purpose.

In view of ongoing research and the constant flow of information relating to the use of medicines, the reader is urged to review and evaluate the information provided in the packet insert or instructions for each medicine, for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions.

Readers should consult with a specialist where appropriate. Neither the publisher nor the authors shall be liable for any damages arising herefrom.