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Xi’an Jiaotong-Liverpool University Featured PhD Programmes
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A novel approach to the development of an anticholinergic tool for measuring cognitive drug burden

Department of Pharmacy & Pharmacology

About the Project

This collaborative project provides an excellent opportunity for the prospective candidate to learn mechanistic approaches to drug pharmacokinetics and translate findings to research in ageing.

Anticholinergic burden occurs when one or more drugs with anticholinergic properties are co-administered. Numerous studies have reported that the anticholinergic burden is a strong predictor of cognitive impairment. The permeability of the blood-brain barrier, as well as altered sensitivity of muscarinic receptors, are some of the critical factors that contribute to cognitive burden.

The current scales tend to simplify the complexity of pharmacological mechanisms of drugs with anticholinergic properties. Importantly, there is no easy way of measuring how well a drug crosses the blood-brain barrier. This property is complex and multifaceted when predicting cognitive outcomes from taking multiple drugs with anticholinergic properties.

We propose to develop a novel anticholinergic burden tool based on pharmacokinetic and psychochemical data. An application will be designed to recognise the potential iatrogenic risk of taking multiple drugs with anticholinergic properties. The application will aid clinicians in improving prescribing for older people.

Applicants should hold, or expect to receive, a First Class or Upper Second Class UK Honours degree (or the equivalent qualification gained outside the UK) in a relevant subject. A master’s level qualification from the disciplines of statistics, pharmacy or medicine would also be advantageous.

Applicants should submit their CV and a one-page expression of interest statement on how their research interests align with pharmacoepidemiology and pharmacokinetics to Dr Prasad Nishtala on email address .

Funding Notes

Applications are welcome year-round from Home/EU/Overseas self-funded students and applicants able to secure funding to cover all costs involved with PhD study including living costs, tuition fees and any bench fees.


1. Nishtala PS, Allore H, Han L, Jamieson HA, Hilmer SN, Chyou TY. Impact of Anticholinergic Burden on Cognitive Performance: A Cohort Study of Community-Dwelling Older Adults [published online ahead of print, 2020 May 8]. Journal of American Medical Directors Association 2020;S1525-8610(20)30286-3. doi:10.1016/j.jamda.2020.03.027
2. Nishtala PS, Salahudeen MS, Hilmer SN. Anticholinergics: Theoretical and Clinical Overview, Expert Opinion in Drug Safety, 2016; 30:1-16.
3. Nishtala PS, Fois RA, McLachlan AJ, Bell JS, Kelly PJ, Chen TF. Anticholinergic activity of commonly prescribed medications and neuropsychiatric adverse events in older people. Journal of Clinical Pharmacology. 2009; 49; 1176-84.

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