Dementia Could Be Increased By Some Drugs

Cheryl Sanders
April 27, 2018

Thus, if someone had a baseline 10% risk of developing dementia in any given year, that risk would increase to 13% with the long-term use of these anticholinergic medications, according to Savva.

The research, funded by Alzheimer's Society and published in the British Medical Journal, looked at the medical records of 40,770 patients aged from 65 to 99 with a diagnosis of dementia between April 2006 and July 2015 and compared them with those of 283,933 people without dementia.

The association was also seen with antidepressants (adjusted OR 1.11, 95% CI 1.08-1.14, P 0.01), they wrote in The BMJ. "And the association with dementia increases with greater exposure to these types of medication".

Use of certain anticholinergic drugs - that help to control involuntary muscle movements for conditions such as Parkinson's disease - is associated with an increased risk of dementia, finds a United Kingdom study published by The BMJ today. "Previously, antihistamines have been implicated (in dementia risk), but we've not found any association between those specifically and dementia, as well as the gastrointestinal drugs", Savva said.

Looking for a statistical correlation, the team found that there was, overall, a "robust association between some classes of anticholinergic drugs and future dementia incidence". However, experts said that patients should keep taking their treatment, as the benefits are higher than the risks of not taking them.

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Dr Noll Campbell, a collaborator and co-author on the paper, said: "These results suggest we should prioritise safer alternatives to anticholinergic medications long before symptoms of dementia are recognised".

The number of older people taking five or more medicines has quadrupled in the past two decades, fuelling the need for more research into the effects of taking a "cocktail" of prescribed drugs, Maidment said.

Frequently prescribed anticholinergic drugs include procyclidine (Kemadrin) for Parkinson's; tolterodine, oxybutynin, and solifenacin (Vesicare) for urological conditions such as overactive bladder or incontinence; and amitriptyline, dosulepin, and paroxetine for depression.

"While there are important advantages to research that uses the rich data held in medical records, we know that less than 70 per cent of people with dementia receive a formal diagnosis, and this study may not tell the whole story".

The researchers do stress that patients prescribed anticholinergic drugs shouldn't just stop taking their medicines. The study didn't investigate what might cause this link between anticholinergics and dementia risk, and researchers will need to build on these findings in future studies.

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"Many of the treatment options for these conditions involve medication with anticholinergic effects".

Drugs were scored according to their anticholinergic activity using the Anticholinergic Cognitive Burden (ACB) scale.

"But the headline claim that some drugs, especially antidepressants, can cause dementia up to 20 years later should be looked at closely".

"Doctors and patients should therefore be vigilant about using anticholinergic medications".

Dr Ian Maidment, Senior Lecturer in Clinical Pharmacy at Aston University and lead pharmacist on the study, said: "We already have strong evidence that anticholinergics cause confusion and in the short-term will potentially worsen the symptoms of dementia. Carry on as usual, and if you're concerned, talk to your doctor or pharmacist".

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