Description of the Anticholinergic Cognitive Burden (ACB) Scale in the National Educational and Methodological Literature 2016-2024

The Anticholinergic Cognitive Burden (ACB) scale, developed in the United States and the United Kingdom in 2008/2012, has been recommended for use in national clinical practice since 2016. Comparison with the original ACB scale shows that in the national educational and methodological literature of 2016/2018 it has been presented in a significantly shortened and partially distorted form. In the 2024 methodological guide, the previously presented national version of ACB scale has been modified again by further reducing the list of drugs with the score of 1 and including in the list of drugs with score of 3 those with strong anticholinergic properties from the 2023 Beers criteria list. In all publications, the ACB scale description has been accompanied by incorrect bibliographic references, and the feasibility of its practical application has been justified by the study of another scale (ARS: Anticholinergic Risk Scale), as well as by the incorrectly presented results of the ACB scale studies. As a consequence, the readers remain uninformed that the use of drugs with the score of 1, primarily cardiovascular drugs, was not associated with the increased risk of developing cognitive impairment in the ACB scale studies.