Date of Award

January 2012

Document Type

Open Access Thesis

Degree Name

Master of Science in Nursing (MSN)


Yale University School of Nursing

First Advisor

Lawrence Scahill


This secondary analysis examined the relationship between the total anticholinergic load and scores on cognitive tests in 94 patients diagnosed with schizophrenia or schizoaffective disorder. Cognitive impairment is a core feature of schizophrenia, and studies have shown that it is a strong predictor of functional outcomes in this population. Anticholinergic medications have been demonstrated to have a negative impact on cognition. Some antipsychotic medications have anticholinergic properties, and anticholinergic medications are often prescribed to patients with schizophrenia to treat or prevent extrapyramidal side effects of antipsychotics. We did not find any significant correlations between anticholinergic load as measured by benztropine equivalents and any of the MATRICS cognitive tests. In addition there were no significant differences in the mean scores of subjects in the highest anticholinergic quartile and subjects in the lowest anticholinergic quartile. These same analyses were performed comparing chlorpromazine equivalents and again there were no statistically significant results. Our results suggest that the anticholinergic load or dose of antipsychotic medication do not significantly contribute to cognitive deficits in patients with schizophrenia or schizoaffective disorder. The relatively small sample size was inadequate to detect a small difference.


This is an Open Access Thesis.

Open Access

This Article is Open Access