Anticholinergics Increase Dementia Risk in Middle-Aged, Older Adults

Grant Boone
June 26, 2019

Overall, they study found an increased risk of dementia among those who took anticholinergic drugs.

"This study provides further evidence that doctors should be careful when prescribing certain drugs that have anticholinergic properties", Tom Dening, who runs the Center for Dementia at the University of Nottingham and study author, said in a news release.

The study had some limitations, including that some patients may not have taken their prescribed medication as directed, so anticholinergic exposure levels could have been misclassified.

The main function of these drugs is to help contract and relax the muscles.

Researchers analyzed medical data on almost 59,000 people with dementia, which they collected between January 2004 and January 2016.

Moreover, the results suggest a significant increase in dementia risk for the anticholinergic antidepressants (adjusted OR [AOR], 1.29; 95% CI, 1.24-1.34), anti-parkinson drugs (AOR, 1.52; 95% CI, 1.16 to 2.00), antipsychotics (AOR, 1.70; 95% CI, 1.53 to 1.90), bladder antimuscarinic drugs (AOR, 1.65; 95% CI, 1.56 to 1.75), and antiepileptic drugs (AOR, 1.39; 95% CI, 1.22-1.57) all for more than 1095 TSDDs.

For the explanation that glance reveals fully an association, extra learn is wished to "give an explanation for whether or now not anticholinergic medicines in actual fact enlighten a reversible probability factor" for dementia, wrote consultants Noll Campbell, Richard Holden and Dr. Malaz Boustani in an editorial that printed alongside the recent glance in JAMA Internal Treatment.

'If patients have concerns, then they should discuss them with their doctor to consider the pros and cons of the treatment they are receiving'. The group had an average age of 82 and 63% were women.

"The risks of this type of medication should be carefully considered by healthcare professionals alongside the benefits when the drugs are prescribed and alternative treatments should be considered where possible", said lead researcher Prof.

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The study was observational and was, therefore, unable to evaluate causality; however, the authors said that if the association was causal, the findings indicated that around 10% of dementia diagnoses were attributable to anticholinergic drug exposure, equating to around 20,000 of the 209,600 new cases of dementia per year in the UK.

Anticholinergic drugs are used for a panoply of reasons-for depression and psychosis, bladder and gastrointestinal conditions, allergies and symptoms of Parkinson's disease.

The researchers found that anticholinergic drugs in general were associated with a higher risk of dementia. After accounting for other risk factors for dementia, the researchers concluded that strong anticholinergic meds were associated with an increased risk of dementia.

Reference: Carol A.C. Coupland, et al.

Experts said the findings had "enormous implications" for millions of Britons, with half of middle-aged people taking one of the medications.

This is a sizeable proportion and is comparable with other modifiable risk factors for dementia, including 5% for midlife hypertension, 3% for diabetes, 14% for later life smoking and 6.5% for physical inactivity.

Quoted in a report in BBC, it was further stated that the cause for this being the medicines prescribed in these cases belong to a family of drugs known as anticholinergics. "This calls for extra caution in prescribing the drug", said Dr Kameshwar Prasad, professor of neurology at AIIMS.

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