When taking common prescription drugs or popular over-the-counter medicines, most people assume they are safe to consume. Unfortunately, sometimes certain side effects aren’t discovered until many years later. This may be the case with a category of drugs called “anticholinergics.” Anticholinergics are commonly found in medicines that treat allergies, asthma, depression, urinary incontinence and insomnia.
Many medications have at least some anticholinergic aspects, and it’s estimated that up to half of all older adults in the United States are currently taking one or more of these medicines, which are commonly used to treat depression, high blood pressure and incontinence.
New research shows that anticholinergic drugs may be linked to dementia, and shockingly, the risks extend to those who took them as far back as two decades ago.
In early 2018, researchers from the United States and Great Britain published the results of a massive long-term study in the medical journal BMJ (formerly known as the British Medical Journal). The study involved 27 million prescriptions as recorded in the medical records of 40,770 patients over age 65 diagnosed with dementia. Researchers compared those medical records to the records of 283,933 older adults without dementia.
They found a greater incidence of dementia among patients who were prescribed anticholinergic antidepressants, anticholinergic bladder medications and anticholinergic Parkinson’s Disease medications than those who were not prescribed these drugs. The more anticholinergic medications the patients took, in terms of dosage and volume, the more likely they were to develop dementia. The research found this even for those who took anticholinergic drugs 20 years ago and then stopped.
“This study is large enough to evaluate the long-term effect and determine that harm may be experienced years before a diagnosis of dementia is made,” said Dr. Noll Campbell, a co-author of the BMJ study, and researcher at the Regenstrief Institute and the Indiana University Center for Aging. Anticholinergic drugs work by blocking a neurotransmitter, called acetylcholine, from delivering brain signals to muscles affecting the digestive and urinary tracts, lungs and other areas of the body. Acetylcholine, however, is also involved in memory and learning.
Past research demonstrates that people with Alzheimer’s Disease, by far the most common type of dementia, have lower than normal levels of acetylcholine. “Physicians should review all the anticholinergic medications — including over-the-counter drugs — that patients of all ages are taking and determine safe ways to take individuals off anticholinergic medications in the interest of preserving brain health,” said co-author Dr. Malaz Boustani.
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