Anticholinergic Burden Calculator

The Anticholinergic Burden Calculator estimates total anticholinergic burden based on current medication lists and patient age. This tool helps healthcare professionals quickly assess cognitive risk and medication safety. Whether you are reviewing a geriatric patient’s prescriptions, evaluating cognitive decline causes, or planning a deprescribing strategy, this tool provides a reliable cumulative score.

Enter the patient's age in years. Anticholinergic effects are more pronounced in older adults.
First-generation antihistamines have strong anticholinergic properties
Tricyclic antidepressants have significant anticholinergic effects
Many antipsychotics have varying degrees of anticholinergic activity
Medications for overactive bladder are designed for their anticholinergic effects
Anticholinergics are used to manage Parkinson's symptoms
Other medications with anticholinergic properties
Enter the number of additional medications with anticholinergic properties not listed above (each counted as 1 point)

How Anticholinergic Burden Score Is Calculated

The Anticholinergic Burden Score measures the cumulative effect of medications that block acetylcholine, a key neurotransmitter in the nervous system. It uses a weighted scoring system to estimate potential cognitive side effects, such as memory loss or confusion.

Total Burden = Σ(Medication Scores) + (Count of Additional Meds)

Where:

  • Medication Scores = 1 (moderate) or 2 (strong) based on potency
  • Additional Meds = Number of unlisted anticholinergic drugs

This standardized method helps clinicians quickly identify potentially inappropriate combinations and quantify the cumulative load on a patient's system.

What Your Anticholinergic Burden Score Means

Your score represents the total weight of medications that may interfere with nerve signals, potentially causing dry mouth, constipation, confusion, or memory problems. A higher number suggests a significantly greater likelihood of these cognitive and physical side effects, particularly in vulnerable populations.

Scores of 0 indicate minimal risk, meaning current medications have very low anticholinergic activity. This is the ideal scenario for patient safety and cognitive health.

Scores of 1 to 2 suggest a moderate burden, which is manageable for many adults but requires close monitoring for early signs of cognitive decline, especially in older patients.

Scores of 3 or higher signal a high risk, especially for patients over 65, and warrant a thorough medication review to reduce the load or find safer alternatives.

This calculator is a screening tool for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making any changes to medication regimens. The results should be interpreted in the context of the individual patient's overall health status and clinical picture.

You should reassess the score whenever a new medication is prescribed or if the patient shows sudden changes in behavior, memory, or physical function.