Anticholinergic Burden (ACB) Calculator

The Anticholinergic Burden Score (ACB Score) is a clinical tool used to measure the cumulative effect of taking one or more medications with anticholinergic properties. Anticholinergic drugs block the neurotransmitter acetylcholine in the nervous system and are used to treat various conditions such as allergies, depression, urinary incontinence, and Parkinson’s disease. However, a high anticholinergic burden is associated with adverse effects, especially in older adults, including cognitive decline, confusion, dry mouth, constipation, urinary retention, and an increased risk of falls and delirium. Each drug is assigned a score from 0 to 3, where:

• 0 = no known anticholinergic activity,
• 1 = possible anticholinergic effects,
• 2 or 3 = definite anticholinergic effects.

The total ACB score is the sum of all individual drug scores and helps healthcare providers assess and minimize the risk of anticholinergic-related side effects.