Published: Fri, April 27, 2018
Medical | By Vernon Walton

Study finds link between popular medications and dementia risk

Study finds link between popular medications and dementia risk

They looked at those with new diagnoses and what anticholinergic medication they were prescribed in the 4 to 20 years prior, identifying 14,453 (35%) patients with dementia and 86,403 (30%) controls who had been prescribed at least one anticholinergic drug with an ACB score of 3.

"Not everyone with the conditions highlighted in the study will be prescribed these particular drugs, and the researchers did not find a link between dementia risk and anticholinergic drugs used to treat allergies, stomach problems or muscle spasms".

Research director Dr. Carol Routledge with the Alzheimer's Research UK said that researchers that started this study should continue looking more into the connection between "anticholinergics and dementia risk, and researchers will need to build on these findings in future studies". "Don't stop taking your medication".

"We don't exactly know within those that are taking these drugs, who is at the increased risk and who isn't", he said. Nevertheless, the team claims, the findings are signficant enough to warrant reduced prescribing anticholinergics, where possible "With many medicines having some anticholinergic activity, one key focus should be de-prescribing", states study co-researcher Ian Maidment, Ph.D., senior lecturer in clinical pharmacy at Aston University in the United Kingdom. "Doctors, nurses and pharmacists need to work with older people and their carers to ensure that they only take medication if the benefits clearly outweigh the harms".

A list of medications with anticholinergic action can be found here.

"A robust association between some classes of anticholinergic drugs and future dementia incidence was observed", the study's authors wrote. More broadly, there was a link between the use of any prescribed antidepressant, antiparkinson, or urologic drug with an anticholinergic activity burden (ACB) score of 3 (i.e. they can cross the blood brain barrier, have definite anticholinergic activity).

They found that people who were on the drugs between four and 20 years earlier were more likely to have been diagnosed with dementia. "And the association with dementia increases with greater exposure to these types of medication".

The researchers, who report their findings in the British Medical Journal, investigated GP records for more than 40,000 people over the age of 65 with dementia and almost 300,000 without dementia.

The researchers, led by the University of East Anglia, stop short of claiming that the drugs cause dementia. "And we found that about 9% of our (dementia) cases had taken anticholinergics in the past, compared to about 6% of our controls".

"Previous studies had really only said that anticholinergics were associated with dementia incidence", said George Savva, researcher of health sciences at the University of East Anglia and a lead author on the study, in a news briefing. Levels of acetylcholine are known to be significantly lower in people with Alzheimer's disease, the most common cause of dementia in older adults, according to the Mayo Clinic. This study provides further evidence that anticholinergic drugs should be avoided when treating patients with Parkinson's disease. The warning to not use anticholinergic drugs in Parkinson's disease is also important.

"When I see patients on these drugs, I now say, 'let's think about other alternatives, ' " Fox said.

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