Am J Psychiatry 1988; 145:342-345
Copyright © 1988 by American Psychiatric Association
Association of low serum anticholinergic levels and cognitive impairment in elderly presurgical patients
PS Miller, JS Richardson, CA Jyu, JS Lemay, M Hiscock and DL Keegan
Department of Psychiatry, University of Saskatchewan, Saskatoon, Canada.
Low-dose scopolamine, given as presurgery medication, resulted in low
levels of serum anticholinergic activity and caused measurable cognitive
impairment in 18 psychiatrically healthy elderly patients. The degree of
impairment was directly related to serum anticholinergic activity levels
and, in the small subgroup of patients scheduled for spinal anesthesia, to
CSF anticholinergic activity. Two of the mental status tests used, the Rey
Auditory-Verbal Learning Test and the Saskatoon Delirium Checklist, were
sensitive enough to detect these mild drug-induced changes, while two other
tests, the Mini-Mental State and the Symbol Digit Modalities Test, were
not.
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