Anticholinergic Burden and Its Impact on Cognitive Performance and Clinical Severity in Elderly Schizophrenia Patients
10.16946/kjsr.2026.29.1.17
- Author:
Jeongmin KIM
1
;
Kayoung KIM
;
Seonjin YIM
;
Joohyun HAN
;
Eunjin KIM
;
Euncheon YANG
;
Homin KIM
Author Information
1. Department of Geriatric Psychiatry, National Center for Mental Health, Seoul, Korea
- Publication Type:Original Article
- From:Korean Journal of Schizophrenia Research
2026;29(1):17-24
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Objectives:This study aimed to examine the association between anticholinergic burden, cognitive function, and clinical severity in elderly patients with schizophrenia to suggest safer medication treatment strategies.
Methods:A cross-sectional study was conducted with 60 patients aged 60-90 years diagnosed with schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria at the National Center for Mental Health. Participants with Clinical Global Impression-Severity (CGS-S) scores ≤4 were included. The Korean Version of the Consortium to Establish a Registry for Alzheimer’s Disease assessment Packet, the 2nd Edition (CERAD-K), CGI-S, and total Anticholinergic Cognitive Burden (ACB) scores were assessed. Statistical analyses included Mann-Whitney tests, Bootstrap analysis of covariance, and Spearman correlations.
Results:The mean age was 69.52±6.33 years, with 66.67% female participants. The mean total ACB score was 4.30±2.42, with 80% of patients having scores ≥3. High ACB group (n=48) showed significantly higher CGI-S scores (3.13±0.73 vs. 2.67±0.49, p=0.030) and lower performance in Word List Memory, Constructional Praxis, and Constructional Recall domains. After adjusting for education year, age, and sex, high ACB group showed significantly lower CERAD-K total score I than the low ACB group (F=5.947, p=0.018). Total ACB score also showed significant negative correlations with CERAD-K total score I (r=-0.32, p=0.011).
Conclusion:High anticholinergic burden in elderly schizophrenia patients was significantly associated with cognitive impairment and symptom severity. These findings suggest the need for careful medication adjustment in this population.
