Anticholinergics Tied to Physical Performance Decline in Older Adults

WEDNESDAY, July 16, 2025 (HealthDay News) — Anticholinergics are associated with physical performance decline in older adults, according to a study published online July 10 in JAMA Network Open.

Shelly L. Gray, Pharm.D., from the University of Washington in Seattle, and colleagues assessed whether anticholinergic exposure is associated with accelerated physical performance decline in older adults. The analysis included 4,283 participants aged 65 years and older in the Adult Changes in Thought study at Kaiser Permanente Washington (February 1994 to March 2020).

The researchers found that compared with nonusers, there was a greater decline rate in gait speed among those with a 10-year total standardized daily dose (SDD) ≥1,096 (mean difference [MD] per year, −0.0132 m/s) and for two-year mean SDD ≥0.5 (MD per year, −0.0101 m/s). The lowest quasi-information criterion was seen for the four-year weighted cumulative exposures model, which showed a significantly greater decline rate per one-unit increase in weighted mean SDD (MD per year, −0.0034 m/s). For grip strength, there were no significant associations between conventional exposures, but the six-year weighted cumulative exposures model had the lowest quasi-information criterion (MD per year, −0.0329 kg).

“Anticholinergics are associated with numerous adverse outcomes in older adults; therefore, it is essential for clinicians to avoid their use when possible, prescribe the lowest effective dose, and periodically reevaluate patients to identify deprescribing opportunities to minimize potential harms,” the authors write.

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