Anticholinergic drugs are given to people for symptoms such as bladder problems, gastrointestinal disorders, Parkinson’s disease, allergies and chronic obstructive pulmonary disease. They contract and relax muscles and work by blocking acetylcholine, which transmits messages through the nervous system.
Although these drugs are already known to cause confusion and memory loss among their short-term side effects, researchers wanted to find out if long-term use could raise people’s risk of developing dementia.
Scientists from the University of Nottingham looked at nearly 59,000 patients to explore the link. The people they studied were 82 years old on average, and 63 percent of them were women. They matched each dementia patient with five control patients who had the same sex, age and general habits.
Then, they assessed their anticholinergic drug exposure by looking at the 10 years preceding their dementia diagnosis (or the equivalent dates among the control patients who don’t have the disease) to find patterns. They also carried out a further analysis that looked at anticholinergic use in the 20 years prior to dementia diagnosis.
As an observational study, the researchers can’t declare conclusively that anticholinergic drugs do cause dementia, but the increased risk associated with the drugs shows that if the association does indeed turn out to be causal, around 10 percent of dementia cases could be attributed to the use of such drugs. Other modifiable risk factors for dementia include smoking in later life, physical inactivity, diabetes and midlife hypertension.
The most frequently prescribed anticholinergic drugs were antidepressants, anti-vertigo, and antimuscarinic drugs for overactive bladder. The researchers say that doctors should consider the risks of these drugs alongside the benefits and consider alternative types of medication wherever possible.
Past studies also link dementia to anticholinergic drugs
Previous studies have reached similar conclusions. For example, a report published in JAMA Internal Medicine linked the long-term use of anticholinergic meds like Benadryl to dementia.
In that study, a team of researchers tracked nearly 3,500 people aged 65 and older who were part of a long-term health study. They examined pharmacy records to determine all the medications each participant had taken in the ten years prior to the study. They then tracked their health for seven years on average, during which time 800 of the participants developed dementia.
When they looked at anticholinergic drug use, the researchers discovered that those who had taken the drugs were more likely to have ended up developing dementia than those who did not take such medications. On top of that, the risk rose with the cumulative dose a person had taken. For example, the use of an anticholinergic drug for three years or longer was associated with a dementia risk that was 54 percent higher than taking the same dosage for three months or less.
Studies like these are a good reminder that it’s important to take a closer look at the medications you and your elderly loved ones are taking. Assess their side effects, and decide whether they are actually providing benefits that are worth taking those risks on.
Your body’s acetylcholine production declines as you age, and blocking its effects with anticholinergics only makes the situation worse in older people. That’s why it’s important to seek alternatives to these drugs, especially natural ones, if you want to keep a clear mind into your golden years.
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