Jaïdi Y, et al. – This examination investigated the effect of a reduction of the anticholinergic burden (AB) on the frequency and severity of behavioral and psychological symptoms of dementia (BPSD), and their repercussion on the care team. The authors found that the reduction of AB in elderly subjects with dementia makes was possible to reduce BPSD as well as caregiver burden. They suggested that recourse to treatments involving an AB must be avoided as far as possible in these patients, and preferential use of non–pharmacological treatment management plans is to be encouraged.

Methods

• It was a prospective, single center study.
• Members were elderly subjects with dementia presenting BPSD (N = 125, mean age 84.4).
• The reduction of the AB was assessed by the Anticholinergic Cognitive Burden Scale.
• BPSD were assessed by the NPI-NH (Neuropsychiatric Inventory-Nursing Home) scale.
• The impact of the reduction of the AB on the BPSD was studied utilizing logistic regression adjusting for the variables of the comprehensive geriatric assessment.

Results

• 71 subjects (56.8%) presenting with probable AD, 32 (25.6%) mixed dementia (AD and vascular), 17 (13.6%) vascular dementia, and 5 (4.0%) Lewy body dementia were incorporated.
• The results of this study showed that reducing the AB by no less than 20% enabled a significant reduction in the frequency X severity scores of the NPI-NH (OR_adjusted = 3.5, CI 95% = 1.6–7.9) and of the occupational disruptiveness score (OR_adjusted = 9.9, CI 95% = 3.6–27.3).