{
  "abstract": "Background/objectives: Anticholinergic medications are associated with cognitive impairment and falls in older adults, yet multicenter evidence from Saudi Arabia remains limited. This study characterized prescribing patterns and factors associated with definite anticholinergic burden among older adults receiving outpatient care.\n\nMethods: This retrospective multicenter cross-sectional study used outpatient records and dispensing data from two tertiary hospitals located in Al Khobar and Al-Ahsa, Saudi Arabia, between 2019 and 2024. Adults aged 60 years or older receiving at least one medication scoring 2 or 3 on the Anticholinergic Cognitive Burden (ACB) scale were included. Robust linear, negative binomial, and logistic regression models examined definite ACB score, additional qualifying medications, and multiple medication use.\n\nResults: The study included 1,664 older adults with 2016 patient-medication instances. Polypharmacy was present in 84.3%, and 17.5% received multiple qualifying medications. Bladder antimuscarinics, antipsychotics, and tricyclic antidepressants accounted for 78.1% of medication instances, while urology, psychiatry, and neurology accounted for 72.0%. A corresponding coded diagnosis was identified for 20.0% of evaluable instances. Polypharmacy, hypertension, depression, Parkinson's disease, schizophrenia, and bipolar disorder were independently associated with all three outcomes. Schizophrenia showed the strongest associations with definite ACB score (B = 2.206; 95% CI, 0.429–3.982), additional medications (incidence rate ratio = 4.395; 95% CI, 2.499–7.732), and multiple medication use (adjusted odds ratio = 8.303; 95% CI, 3.275–21.055).\n\nConclusions: Definite anticholinergic use was concentrated within a limited number of medication classes and prescribing specialties. Psychiatric disorders and polypharmacy were consistently associated with higher burden, supporting targeted medication review in these patients and specialties.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pharmacy Practice, College of Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia",
    "Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia",
    "Department of Pharmacy Practice, College of Pharmacy, Purdue University, West Lafayette, IN, United States",
    "Department of Pharmacy Practice, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt",
    "Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim, Saudi Arabia",
    "Department of Pharmacy Practice, College of Pharmacy, Najran University, Najran, Saudi Arabia",
    "Clinical Trial Unit, Translational Medical Research Center, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia",
    "Department of Psychiatry, Imam Abdulrahman Bin Faisal Hospital, Ministry of National Guard Health Affairs, Dammam, Saudi Arabia"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 18,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Khalid A. Alamer"
    },
    {
      "affs": [
        1
      ],
      "name": "Mohamed A. Albekery"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Noha Keshk"
    },
    {
      "affs": [
        0
      ],
      "name": "Fawaz M. Alotaibi"
    },
    {
      "affs": [
        4
      ],
      "name": "Ibrahim S. Alhomoud"
    },
    {
      "affs": [
        5
      ],
      "name": "Ali H. Alwadai"
    },
    {
      "affs": [
        1
      ],
      "name": "Mansour M. Alotaibi"
    },
    {
      "affs": [
        0
      ],
      "name": "Ahmad M. Almuslim"
    },
    {
      "affs": [
        0
      ],
      "name": "Ali H. Nasfan"
    },
    {
      "affs": [
        6
      ],
      "name": "Munthir Abdulmajeed Aldukhi"
    },
    {
      "affs": [
        0
      ],
      "name": "Turki Aldossary"
    },
    {
      "affs": [
        7
      ],
      "name": "Nemer AlMosyab"
    },
    {
      "affs": [
        1
      ],
      "name": "Khaled S. Alnaim"
    },
    {
      "affs": [
        1
      ],
      "name": "Wassan A. Alnaim"
    },
    {
      "affs": [
        4
      ],
      "name": "Yasser A. Alharbi"
    },
    {
      "affs": [
        1
      ],
      "name": "Mohammed Y. Shabib"
    },
    {
      "affs": [
        1
      ],
      "name": "Rawan M. Alhulibi"
    },
    {
      "affs": [
        1
      ],
      "name": "Norah A. Alayesh"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/asqmq6xmj6dmf.bib",
  "cited_by": 0,
  "doi": "10.3389/fmed.2026.1974639",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13710337/",
  "id": "asqmq6xmj6dmf",
  "issns": [
    "2296-858X"
  ],
  "landing_url": "https://doi.org/10.3389/fmed.2026.1974639",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
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      "openalex",
      "2717|Pharmaceutical Practices and Patient Outcomes"
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  "openalex": "W7221669681",
  "pdf_url": "https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1974639/pdf",
  "pmcid": "PMC13710337",
  "pmid": "42947851",
  "published": "2026-10-13",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/asqmq6xmj6dmf.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:21:19Z",
      "native_id": "PMC13710337",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fmed.2026.1974639"
    }
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      "field": "medicine",
      "origin": "openalex:2717|Pharmaceutical Practices and Patient Outcomes",
      "subfield": "general"
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  ],
  "title": "Predictors and prescribing patterns of definite anticholinergic medication use among community-dwelling older adults in Saudi Arabia: a retrospective multicenter cross-sectional study",
  "title_text": "Predictors and prescribing patterns of definite anticholinergic medication use among community-dwelling older adults in Saudi Arabia: a retrospective multicenter cross-sectional study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:21:19Z",
  "url": "https://research.draconitic.com/paper/asqmq6xmj6dmf",
  "venue": "Frontiers in Medicine",
  "versions": []
}