Serum anticholinergic activity in hospitalized older persons with delirium: A preliminary study

J. R. Mach, M. W. Dysken, M. Kuskowski, E. Richelson, L. Holden, K. M. Jilk

Research output: Contribution to journalArticle

98 Citations (Scopus)

Abstract

OBJECTIVE: To evaluate the relationship between total serum anticholinergic activity (SAA) and the presence or absence of delirium in older hospitalized persons on general medical wards. DESIGN: Case-control study and within-subjects repeated-measures in recovered delirious patients. SETTING: Minneapolis Veterans Affairs Medical Center medical wards. PARTICIPANTS: Eleven male delirious patients (DSM-III-R criteria) aged 60 or older and 11 comparably aged male nondelirious controls. MEASUREMENTS: Radioreceptor bioassay of total SAA using tritiated quinuclidinyl benzilate (QNB) binding to muscarinic receptors. Results are expressed in terms of atropine equivalents (nM). MAIN RESULTS: Mean SAA was significantly elevated in the delirious group (mean ± SD = 6.05 ± 2.97 nM atropine equivalents) compared with the controls (3.38 ± 2.49; t(20) = 2.28, P < .05). At study entry, mean SAA was significantly higher in delirious subjects whose symptoms eventually resolved completely (mean ± SD = 7.77 ± 2.37) compared with subjects whose delirious symptoms persisted (3.99 ± 2.30; t(9) = 2.68, P < .05). All six patients in whom delirium resolved completely had a decrease in serum anticholinergic activity when measured during delirium (7.77 ± 2.37) and after symptom resolution (3.92 ± 2.61; t(5) = 3.29, P < .05). CONCLUSIONS: Our findings suggest that serum anticholinergic activity may play a role in delirium in medical inpatients. The relationships between SAA and delirium in medical patients and between total SAA and medication use warrant further study.

Original languageEnglish (US)
Pages (from-to)491-495
Number of pages5
JournalJournal of the American Geriatrics Society
Volume43
Issue number5
StatePublished - 1995

Fingerprint

Delirium
Cholinergic Antagonists
Serum
Atropine
Quinuclidinyl Benzilate
Patients' Rooms
Muscarinic Receptors
Veterans
Diagnostic and Statistical Manual of Mental Disorders
Biological Assay
Case-Control Studies
Inpatients

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Mach, J. R., Dysken, M. W., Kuskowski, M., Richelson, E., Holden, L., & Jilk, K. M. (1995). Serum anticholinergic activity in hospitalized older persons with delirium: A preliminary study. Journal of the American Geriatrics Society, 43(5), 491-495.

Serum anticholinergic activity in hospitalized older persons with delirium : A preliminary study. / Mach, J. R.; Dysken, M. W.; Kuskowski, M.; Richelson, E.; Holden, L.; Jilk, K. M.

In: Journal of the American Geriatrics Society, Vol. 43, No. 5, 1995, p. 491-495.

Research output: Contribution to journalArticle

Mach, JR, Dysken, MW, Kuskowski, M, Richelson, E, Holden, L & Jilk, KM 1995, 'Serum anticholinergic activity in hospitalized older persons with delirium: A preliminary study', Journal of the American Geriatrics Society, vol. 43, no. 5, pp. 491-495.
Mach, J. R. ; Dysken, M. W. ; Kuskowski, M. ; Richelson, E. ; Holden, L. ; Jilk, K. M. / Serum anticholinergic activity in hospitalized older persons with delirium : A preliminary study. In: Journal of the American Geriatrics Society. 1995 ; Vol. 43, No. 5. pp. 491-495.
@article{4907f797bb3643db9af89fcb96089ed6,
title = "Serum anticholinergic activity in hospitalized older persons with delirium: A preliminary study",
abstract = "OBJECTIVE: To evaluate the relationship between total serum anticholinergic activity (SAA) and the presence or absence of delirium in older hospitalized persons on general medical wards. DESIGN: Case-control study and within-subjects repeated-measures in recovered delirious patients. SETTING: Minneapolis Veterans Affairs Medical Center medical wards. PARTICIPANTS: Eleven male delirious patients (DSM-III-R criteria) aged 60 or older and 11 comparably aged male nondelirious controls. MEASUREMENTS: Radioreceptor bioassay of total SAA using tritiated quinuclidinyl benzilate (QNB) binding to muscarinic receptors. Results are expressed in terms of atropine equivalents (nM). MAIN RESULTS: Mean SAA was significantly elevated in the delirious group (mean ± SD = 6.05 ± 2.97 nM atropine equivalents) compared with the controls (3.38 ± 2.49; t(20) = 2.28, P < .05). At study entry, mean SAA was significantly higher in delirious subjects whose symptoms eventually resolved completely (mean ± SD = 7.77 ± 2.37) compared with subjects whose delirious symptoms persisted (3.99 ± 2.30; t(9) = 2.68, P < .05). All six patients in whom delirium resolved completely had a decrease in serum anticholinergic activity when measured during delirium (7.77 ± 2.37) and after symptom resolution (3.92 ± 2.61; t(5) = 3.29, P < .05). CONCLUSIONS: Our findings suggest that serum anticholinergic activity may play a role in delirium in medical inpatients. The relationships between SAA and delirium in medical patients and between total SAA and medication use warrant further study.",
author = "Mach, {J. R.} and Dysken, {M. W.} and M. Kuskowski and E. Richelson and L. Holden and Jilk, {K. M.}",
year = "1995",
language = "English (US)",
volume = "43",
pages = "491--495",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Serum anticholinergic activity in hospitalized older persons with delirium

T2 - A preliminary study

AU - Mach, J. R.

AU - Dysken, M. W.

AU - Kuskowski, M.

AU - Richelson, E.

AU - Holden, L.

AU - Jilk, K. M.

PY - 1995

Y1 - 1995

N2 - OBJECTIVE: To evaluate the relationship between total serum anticholinergic activity (SAA) and the presence or absence of delirium in older hospitalized persons on general medical wards. DESIGN: Case-control study and within-subjects repeated-measures in recovered delirious patients. SETTING: Minneapolis Veterans Affairs Medical Center medical wards. PARTICIPANTS: Eleven male delirious patients (DSM-III-R criteria) aged 60 or older and 11 comparably aged male nondelirious controls. MEASUREMENTS: Radioreceptor bioassay of total SAA using tritiated quinuclidinyl benzilate (QNB) binding to muscarinic receptors. Results are expressed in terms of atropine equivalents (nM). MAIN RESULTS: Mean SAA was significantly elevated in the delirious group (mean ± SD = 6.05 ± 2.97 nM atropine equivalents) compared with the controls (3.38 ± 2.49; t(20) = 2.28, P < .05). At study entry, mean SAA was significantly higher in delirious subjects whose symptoms eventually resolved completely (mean ± SD = 7.77 ± 2.37) compared with subjects whose delirious symptoms persisted (3.99 ± 2.30; t(9) = 2.68, P < .05). All six patients in whom delirium resolved completely had a decrease in serum anticholinergic activity when measured during delirium (7.77 ± 2.37) and after symptom resolution (3.92 ± 2.61; t(5) = 3.29, P < .05). CONCLUSIONS: Our findings suggest that serum anticholinergic activity may play a role in delirium in medical inpatients. The relationships between SAA and delirium in medical patients and between total SAA and medication use warrant further study.

AB - OBJECTIVE: To evaluate the relationship between total serum anticholinergic activity (SAA) and the presence or absence of delirium in older hospitalized persons on general medical wards. DESIGN: Case-control study and within-subjects repeated-measures in recovered delirious patients. SETTING: Minneapolis Veterans Affairs Medical Center medical wards. PARTICIPANTS: Eleven male delirious patients (DSM-III-R criteria) aged 60 or older and 11 comparably aged male nondelirious controls. MEASUREMENTS: Radioreceptor bioassay of total SAA using tritiated quinuclidinyl benzilate (QNB) binding to muscarinic receptors. Results are expressed in terms of atropine equivalents (nM). MAIN RESULTS: Mean SAA was significantly elevated in the delirious group (mean ± SD = 6.05 ± 2.97 nM atropine equivalents) compared with the controls (3.38 ± 2.49; t(20) = 2.28, P < .05). At study entry, mean SAA was significantly higher in delirious subjects whose symptoms eventually resolved completely (mean ± SD = 7.77 ± 2.37) compared with subjects whose delirious symptoms persisted (3.99 ± 2.30; t(9) = 2.68, P < .05). All six patients in whom delirium resolved completely had a decrease in serum anticholinergic activity when measured during delirium (7.77 ± 2.37) and after symptom resolution (3.92 ± 2.61; t(5) = 3.29, P < .05). CONCLUSIONS: Our findings suggest that serum anticholinergic activity may play a role in delirium in medical inpatients. The relationships between SAA and delirium in medical patients and between total SAA and medication use warrant further study.

UR - http://www.scopus.com/inward/record.url?scp=0029071961&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029071961&partnerID=8YFLogxK

M3 - Article

C2 - 7730529

AN - SCOPUS:0029071961

VL - 43

SP - 491

EP - 495

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

SN - 0002-8614

IS - 5

ER -