What is one potential consequence of a high anticholinergic burden in patients?

High anticholinergic burden refers to the cumulative effect of taking multiple medications with anticholinergic properties, which can interfere with the neurotransmitter acetylcholine in the central and peripheral nervous systems. One significant consequence of this burden is an increased risk of confusion, especially in older adults. This confusion can manifest as cognitive impairment, delirium, or exacerbation of pre-existing cognitive decline, as anticholinergic agents can inhibit cognitive processes necessary for normal function and memory.

Anticholinergic drugs work by blocking the action of acetylcholine, which is crucial for various brain functions, including thought, learning, and memory. In older patients, who may already have lower levels of acetylcholine or existing cognitive vulnerability, the introduction of additional anticholinergic medications can destabilize their cognitive state, leading to confusion and other cognitive difficulties. Therefore, managing the anticholinergic burden is critical in minimizing these cognitive risks in patients.