Association between anticholinergic activity and xerostomia and/ or xerophthalmia in the elderly: systematic review

Prado-Mel, E.; Ciudad-Gutiérrez, P.; Rodríguez-Ramallo, H.; Sánchez-Fidalgo, S.; Santos-Ramos, B.; Villalba-Moreno, A. M.

doi:10.1186/s40360-022-00637-8

Table 4 Association between anticholinergic burden or anticholinergic use and xerostomia and xerophthalmia

From: Association between anticholinergic activity and xerostomia and/ or xerophthalmia in the elderly: systematic review

Relation studied	Study. year	Scale	Peripherical adverse effect	Patient’s groups compared when looking for a correlation	Association	Association magnitude
Anticholinergic drug use and peripheral effects	Thomson WM. 1993	No Scale	Xerostomia	Occurrence of reported dry mouth in patients taking anticholinergics drugs vs patient not taken	+	50% vs 19% (p = 0.02) ^b
	Katz IR. 1988	No Scale	Xerostomia	Dry mouth reported by patients that taking anticholinergics drugs (PNS + CNS) vs patients not taking anticholinergic drugs	+	69% vs 29% (p < 0.05) ^c
	Katz IR. 1988	No Scale	Xerostomia	Dry mouth reported by patients that taking anticholinergics drugs (CNS) vs patients not taking anticholinergic drugs	+	64% vs 29% (p < 0.05) ^c
	Ness J. 2006	No Scale	Xerostomia	Used at least 1 anticholinergic agent vs did not use any anticholinergic	+	−0.7((−1.1)-0.3) (p < 0.01)^d
	Ness J. 2006	No Scale	Xerophthalmia		–	−0.2 ((−0.3)-(−0.1) (p = 0.39)^d
	Desoutter A. 2011	No Scale	Xerostomia	Patients with anticholinergics drug use vs patients without anticholinergic drugs	+	1.35 (1.05–1.73) (p = 0.02)^e
Anticholinergic burden and peripheral effects	Rudolph JL. 2008	ARS	Peripheral adverse events^a	Retrospective cohort: ARS = 0, ARS = 1–2 vs ARS ≥ 3	+	1.4 (1.0–1.9)^f
	Rudolph JL. 2008	ARS	Peripheral adverse events^a	Prospective cohort ARS = 0,ARS = 1–2 vs ARS ≥ 3	+	2.1 (1.5–2.9)^f
	Kersten H. 2012	ADS	Xerostomia	ADS = 3 vs ADS = 4	–	0.0 (−0.3-(0.3))^g
				ADS = 3 vs ADS = 5	–	− 0.1 (− 0.3-(0.2))^g
				ADS = 3 vs ADS≥6	+	−0.4 (− 0.7-(0.1)) (p < 0.001)^g
	Kersten H. 2013	ADS	Xerostomia	Intervention group vs control group	–	−0.07 (− 0.21–0.07) (p = 0.34)^h
	Tiisanoja A. 2017	ADS	Salivary estimulated secretion	ADS = 0 vs ADS≥3	–	1.50 (0.80–2.81) ⁱ
			Salivary unestimulated secretion	ADS = 0 vs ADS≥3	+	2.31 (1.22–4.43)ⁱ
			Xerostomia	ADS = 0 vs ADS≥3	+	3.17 (1.44–6.96)ⁱ
	Inkeri NM. 2019	ARS	Xerophthalmia	ARS = 0 vs ARS > 0	–	No numerical data available
			Xerophthalmia	Diabetic patients with ARS = 0 vs diabetic patients with ARS > 0	–	No numerical data available
			Xerostomia	ARS = 0 vs ARS > 0	–	No numerical data available
			Xerostomia	Diabetic patients with ARS = 0 vs diabetic patients with ARS > 0	–	No numerical data available
	Lavrador M. 2021	ARS	Xerophthalmia	Differences between the median of anticholinergic burden scale scores in patients with xerostomia or xeropthalmia vs the median of anticholinergic burden scale scores in patients without xerostomia or xeropthalmia	+	1.0 vs 0.0 (p = 0.001)^j
		ARS	Xerostomia		+	1.0 vs 0.0 (p < 0.001)^j
		ADS	Xerophthalmia		+	2.0 vs 2.0 (p = 0.020)^j
		ADS	Xerostomia		+	2.0 vs 1.5 (p < 0.001)^j
		ACB	Xerophthalmia		+	3.0 vs 1.0 (p < 0.001)^j
		ACB	Xerostomia		+	2.0 vs 1.0 (p < 0.001)^j
		DBI	Xerophthalmia		+	0.96 vs 0.50 (p < 0.001)^j
		DBI	Xerostomia		+	0.75 vs 0.13 (p < 0.001)^j

^aPeripherical adverse effects: adverse effects include dry mouth, dry eyes and constipation. ^bChi square test; ^c Pearson χ2; ^dAnalysis of variance for continuous variables; ^eOdd Ratio, predictors of xerostomia identified by multivariable analysis; ^fRelative Risk adjusted for age and number of medications; ^gAnalysis of covariance performed with log-transformed data; ^hAnalysis of covariance between the groups analysed; ^IRelative Risk adjusted by age, gender, education, diabetes and rheumatoid disease, and the Functional Comorbidity Index by a Poisson regression model; ^jMann-Whitney test
ACB: Anticholinergic Cognitive Burden Scale; ADS: Anticholinergic Drug Scale; ARS: Anticholinergic Risk Scale; CNS: central nervous system; DBI: Drug Burden Index; PNS: peripheral nervous system;

Back to article page

ISSN: 2050-6511

Contact us

General enquiries: journalsubmissions@springernature.com

BMC Pharmacology and Toxicology

Contact us