1 Introduction
Elderly people commonly suffer from multiple chronicconditions and treatment of these conditions can lead to polypharmacy. Both polypharmacy and aging can lead to altered pharmacokinetics and pharmacodynamics. Consequently the elderly are prone to adverse drug reactions stemming from the use of inappropriate medications [1–3]. Inappropriate medications are an important aspect of suboptimal prescribing in the elderly. Although the treatment guidelines such as the Beers criteria are available to identify drugs deemed inappropriate for use in the elderly (age C65 years), approximately 20–30 % of these patients use such agents in the USA [4, 5]. The Beers list includes
drugs with anticholinergic properties which are deemed potentially inappropriate because of adverse effects or limited effectiveness in elderly people [6]. The most recent update of the Beers list from the American Geriatrics Society continues to specifically recommend avoidance of anticholinergics in people with dementia, as have prior versions