University of Oulu

Rinkinen, MO., Roitto, HM., Öhman, H.R. et al. Temporal Trends Over Two Decades in the Use of Anticholinergic Drugs Among Older Community-Dwelling People in Helsinki, Finland. Drugs Aging 39, 705–713 (2022).

Temporal trends over two decades in the use of anticholinergic drugs among older community-dwelling people in Helsinki, Finland

Saved in:
Author: Rinkinen, Mikko-Oskari1; Roitto, Hanna-Maria2,3,4; Öhman, Hanna R.3;
Organizations: 1Department of General Practice and Primary Health Care, University of Helsinki, PO Box 20, 00014, Helsinki, Finland
2Department of Neurosciences, University of Helsinki, Helsinki, Finland
3Clinics of Internal Medicine and Rehabilitation, Division of Geriatrics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
4Finnish Institute for Health and Welfare, Population Health Unit, Helsinki, Finland
5Center of Life Course Health Research, University of Oulu, Oulu, Finland
6Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
7Social and Health Care Services, City of Helsinki, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
Persistent link:
Language: English
Published: Springer Nature, 2022
Publish Date: 2022-11-30


Background: Knowledge of the adverse effects of drugs with anticholinergic properties (DAPs) has increased in recent decades. However, research on the temporal trends of the clinical use of DAPs is still sparse.

Objectives: The aim of this study was to investigate the temporal trends of DAP use over two decades in the older community-dwelling population and to explore the medication classes contributing to the use of DAPs.

Methods: The study involved random samples of ≥ 75-year-old community-dwelling Helsinki citizens in 1999, 2009, and 2019 from the Helsinki Ageing Study. A postal questionnaire inquired about their health, functioning, and medications. The medications were categorized as DAPs according to Duran’s list. In addition, we grouped DAPs into various medication groups.

Results: The prevalence and burden of DAPs on Duran’s list showed a decreasing trend over the years. In 1999 the prevalence was 20% and the burden 0.35, in 2009 they were 22% and 0.35, respectively, and in 2019 they were 16% and 0.23, respectively. There were no differences in how the 75- and 80-year-olds used DAPs compared with those aged 85 years and older. The proportion of typical antipsychotics, benzodiazepines, hypnotics, urinary antispasmodics, and asthma/chronic obstructive pulmonary disease medications decreased, whereas the proportion of atypical antipsychotics, antidepressants, strong opioids, and antihistamines increased. In particular the use of mirtazapine increased—to 3.9% in 2019. In 2019 the three most prevalent groups of DAPs were antidepressants (7.4%), opioids (2.7%), and antihistamines (2.4%).

Conclusions: The decrease in the use of DAPs on Duran’s list is a welcome change. Although the use of old, strong DAPs has decreased, new DAPs have simultaneously emerged. Physicians need continuous education in prescribing DAPs and more recent information on the use and effects of DAPs is needed in order to decrease their exposure among the rapidly growing older population.

see all

Series: Drugs & aging
ISSN: 1170-229X
ISSN-E: 1179-1969
ISSN-L: 1170-229X
Volume: 39
Issue: 9
Pages: 705 - 713
DOI: 10.1007/s40266-022-00968-5
Type of Publication: A1 Journal article – refereed
Field of Science: 317 Pharmacy
Funding: Open access funding provided by University of Helsinki including Helsinki University Central Hospital. This study was supported by the Päivikki and Sakari Sohlberg Foundation and Helsinki University Hospital VTR (Valtion tutkimusrahoitus) funding.
Copyright information: © The Author(s) 2022, corrected publication 2022. This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit