Limitation of inappropriate prescribing must be a medical concern in daily practice especially in older patients. In particular, anti-cholinergic drugs (anti-ACh), which are not all explicitly classified as anti-ACh, are commonly prescribed for a wide range of indications (pulmonary obstructive diseases, anxiety, insomnia, urinary incontinence, Parkinson's disease, congestive heart failure). Their prescription is however associated with a reduced quality of life and increased morbidity and mortality. Tools detecting inappropriate prescriptions and clinical scales that quantify the anti-ACh burden contribute, despite some limitations, to secure and optimize these drugs' prescription in this vulnerable population.