Anticholinergic Drugs Increase The Risk Of Dementia.
Anticholinergic drugs often prescribed by doctors to treat an array of conditions such as chronic obstructive pulmonary disease, bladder conditions, allergies, gastrointestinal disorders and symptoms of Parkinson’s disease. They help to contract and relax muscles. They work by blocking acetylcholine, a chemical that transmits signals in the nervous system.
Researchers from the University of Nottingham discovered that that there was nearly a 50% increased risk of dementia among patients aged 55 and above who had used strong anticholinergic medication daily for more than three years.
Already, these drugs can have short-term side effects, including confusion and memory loss, but the latest study has shown that they also have long-term negative effects on patients by increasing the risk of dementia.
The study, involving data analysis of the medical records of 58,769 patients with a diagnosis of dementia and 225,574 patients without dementia, all aged 55 and over and registered with UK GPs contributing data to the QResearch database, between 1 January 2004 and 31 January 2016.
Findings from the study revealed increased risks of dementia for anticholinergic drugs overall and specifically for the anticholinergic antidepressants, antipsychotic drugs, antiparkinsons drugs, bladder drugs and epilepsy drugs after accounting for other risk factors for dementia. No increased risks were found for the other types of anticholinergic medications studied such as antihistamines and gastrointestinal drugs.
"This study proves that healthcare professionals should be cautious when prescribing certain drugs that have anticholinergic properties.It is important however that patients taking drugs of this kind don’t just stop them abruptly as this may be more harmful. If patients have concerns, they should discuss them with their doctor to consider the pros and cons of the treatment they are under."said Professor Tom Dening from the study team in a phone interview with Thailand Medical News.
The risks of this type of medication should be carefully considered by doctors alongside the benefits when the drugs are prescribed and alternative treatments should be considered where possible, such as other types of antidepressants or alternative types of treatment for bladder conditions or other diseases. These findings also highlight the importance of carrying out regular medication reviews.
In the study, anticholinergic drug usage was assessed using prescription data over a complete period of 10 years from 1 to 11 years before diagnosis of dementia or the equivalent dates in control patients, and was compared between the two patient groups. Detailed analysis looked at prescriptions for anticholinergic drugs up to 20 years before diagnosis of dementia.
A greater risk for people diagnosed with dementia before the age of 80 was found which indicates that anticholinergic drugs should be prescribed with caution in middle-aged people as well as in older people. In the 1-11 years before the dementia diagnosis date or equivalent in controls, nearly 57% of cases and 51% of controls were prescribed at least one strong anticholinergic drug, with an average of six prescriptions in cases and 4 in controls. The most frequently-prescribed types of drugs were antidepressants, anti-vertigo and bladder antimuscarinic drugs, which are used to treat an overactive bladder.
The increased risk associated with these drugs indicates
that if the association is causal around 10% of dementia diagnoses could be attributable to anticholinergic drug exposure, which would equate to around 20,000 of the 209,600 new cases of dementia per year in the UK alone. Global figures were not available as of press time.