Summary: The cholinolytic syndrome is a result of cholinergic transmission blockade in the central nervous system and peripheral organs. The most important clinical symptom in the elderly is delirium and cognitive decline, additionally peripheral symptoms may appear: tachycardia, dry mucous membranes, urinary retention or constipation. In majority of medications taken by patients, the anticholinergic propertiy is a side effect. There are several scales that group medications according to the strength of anticholinergic activity, however, the cumulative effect of all drugs taken is cricial. Treatment of the cholinolytic syndrome is symptomatic, and discontinuation of anticholinergic drugs and avoidance of polypharmacy play a key role.