Evaluation of Anticholinergic Load
Evaluation of Anticholinergic Load
Drugs with anticholinergic properties may cause central and peripheral side effects. Several
 scales have been developed to evaluate the anticholinergic effect of drugs. Numerous studies
 have been published, showing a link between the anticholinergic load and the occurrence of
 adverse effects in the elderly.

 Anticholinergic Cognitive Burden is a scale that identifies the severity of adverse effects
 of anticholinergic drugs specifically on cognition including cognitive decline, mental
 confusion, mild cognitive impairment, and dementia. It was developed from reviews of the
 medical literature and the calculation of drug affinities for muscarinic receptors. This list
 of drugs was presented to a team of experts including geriatricians, psychogeriatrists
 geriatric nurses and pharmacists, who assigned these drugs three scores ranging from 1 to 3:

 -  score 1: drugs with a possible anticholinergic effect on cognition demonstrated in vitro
 by its affinity for the muscarinic receptor or by calculation of the ASA level
 (anticholinergic activity of the serum), but without relevant clinical evidence of
 cognitive adverse effects;

 -  scores 2 and 3: drugs whose moderate or severe anticholinergic effect on cognition has
 been clearly established clinically. The drugs of scores 2 or 3 are differentiated by
 their ability to cause confusion and their properties to penetrate or not the
 blood-brain barrier.

 The sum of the scores of the different drugs taken by the patient determines the cumulative
 cognitive risk score related to anticholinergics.

 This ACB scale seems to be the most relevant in Parkinsonian patients.

 Parkinson's disease (PD) is described for the first time in 1817 by an English doctor who
 gives it his name.

 Parkinson's disease is a chronic, slowly progressive condition defined by the presence of
 motor symptoms (resting tremor, slowness and difficulty of movement or bradykinesia, muscle
 rigidity, equilibrium disorders) associated with variable non-motor symptoms ( such as
 constipation, fatigue, depression and anxiety, sleep disorders, impaired sense of smell,
 cognitive disorders). Age is the main risk factor for the disease (?).

 There is a significant increase in the number of cases due to the aging of the population and
 the improvement in life expectancy.

 By 2030, the number of Parkinson's patients could increase by 56% with 1 in 120 people over
 45 with the disease.

 Parkinsonian patients are subjected to a higher anticholinergic load, by the therapeutics
 used in their pathologies (antidepressants, neuroleptics, antiparkinsonians, etc ...).

 These central and peripheral anticholinergic effects may add to the symptomatology in
 Parkinson's patients and aggravate their pathology.

 My study project aims to improve the management of elderly patients with Parkinson's disease.

 Hypothesis: People involved in the management of Parkinson's patients are not always aware of
 the potential anticholinergic effects of drugs. Indeed, anticholinergic effects can be
 responsible for many hospitalizations in the elderly.

 This is why we want to make an inventory of treatments in Parkinson's patients at the
 entrance of hospitalization by evaluating the anticholinergic load using the ACB scale and
 the hospitalization exit in order to know if this score changed after informing the doctors
 responsible
Inclusion Criteria:

 -  Parkinson's disease

 Exclusion Criteria:

 -  age < 18 years