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4AT (Rapid Assessment Test for Delirium)ACS-NSQIP Surgical Risk CalculatorAD8 Dementia ScreeningAnticholinergic Burden Score (ACB)Barthel IndexBeers Criteria (PIMs)Berg Balance ScaleBraden ScaleCAM — Confusion Assessment MethodClinical Dementia Rating (CDR)Clinical Frailty Scale (CFS)Clock Drawing Test (CDT)Cornell Scale for Depression (CSDD)DOSS (Delirium Observation Screening Scale)DRS-R-98 (Delirium Rating Scale)Drug Burden Index (DBI)Edmonton Frail Scale (EFS)FRAIL ScaleFried Frailty PhenotypeFunctional Independence Measure (FIM)Functional Reach TestGeriatric Depression Scale (GDS-15)Groningen Frailty Indicator (GFI)HELP Score (Postoperative Delirium Risk)Hendrich II Fall Risk ModelICIQ-UI SFinterRAI Clinical AssessmentIQCODEKatz Index of Independence in ADLsLawton Instrumental ADL ScalemFI-5 Preoperative FrailtyMini Nutritional Assessment (MNA) - FullMini-CogMMSEMNA-SF (Short Form)Morse Fall ScaleMUST (Malnutrition Universal Screening Tool)Norton ScaleOAB-V8OST (Osteoporosis Screening Tool)OSTA (Osteoporosis Self-Assessment Tool for Asians)Six-Item Screener (SIS)SPMSQSTOPP/START CriteriaSTRATIFY Risk Assessment ToolTimed Up and Go (TUG) TestTriage Risk Screening Tool (TRST)Waterlow Score
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Anticholinergic Burden Score (ACB)

ACB Score: Sum of anticholinergic drug scores. Total ≥ 3 = clinically significant cumulative burden.
Guidelines & Evidence

Verified

Last Review: 2026

When to Use

When to Use

Medication review in adults ≥65 at risk of cognitive impairment or falls.
Preoperative polypharmacy assessment in older surgical patients.
Evaluating possible drug-induced delirium or unexplained cognitive decline.
Pharmacy-led deprescribing initiatives in nursing home and primary care settings.

Why Anticholinergics Matter in Older Adults

Anticholinergic drugs block muscarinic receptors in the brain and periphery. In older adults, age-related reductions in acetylcholine production and blood-brain barrier integrity dramatically increase susceptibility to cognitive side effects — even at doses tolerated in younger patients.

Related Scores in Practice

In clinical practice, this assessment is frequently evaluated alongside other validated measures. Depending on the patient's presentation and specific diagnostic requirements, you may also need to utilize the Beers Criteria (PIMs), STOPP/START Criteria or the Drug Burden Index (DBI) to formulate a comprehensive care plan.

Last Comprehensive Review: 2026

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