Grant: Operating Grant

A wide variety of medications possess anticholinergic properties, meaning they block a chemical called acetylcholine in the body. The anticholinergic effects of these drugs can be especially concerning in older adults for several reasons. First, they can lead to acute urinary retention (the sudden, painful inability to void). Second, anticholinergic drugs can also interfere with memory and thinking, which is especially dangerous for older people with dementia. In fact, another group of drugs called the cholinesterase inhibitors, which are used to treat dementia, essentially have the opposite effect of anticholinergic drugs. Despite their opposing actions, anticholinergics and cholinesterase inhibitors are sometimes prescribed together. This practice may provoke serious adverse effects such as acute urinary retention and worsening confusion. We will find out how commonly these drugs with opposing actions are prescribed together, and whether this prescribing practice leads to safety problems in frail older adults with dementia. If we find evidence of harm, a policy to help alert physicians to the hazards of co-prescribing these drugs may help to limit this problem.