Are Common Prescriptions Leading To Dementia?

A recent scientific study suggests that the risk of dementia increases with the use of  anticholinergic drugs. Anticholinergic drugs contain substances that block the neurotransmitter acetylcholine in certain parts of the nervous system, and they are commonly prescribed to treat everything from depression to an overactive bladder.

JAMA Internal Medicine, a peer-reviewed medical journal published online weekly and in print monthly by the American Medical Association released the study earlier this week. Researchers indicated that the odds of developing dementia can increase by nearly 50% in people that take strong anticholinergic medication daily for at least three years versus those people that don’t take any.

According to Carol Coupland, professor of medical statistics in primary care at the University of Nottingham, “The study is important because it strengthens a growing body of evidence that strong anticholinergic drugs have long term associations with dementia risk.” She also pointed out that since this was only an observational study, there are still no firm conclusions concerning whether taking these drugs result in dementia, so people are advised to consult their doctors before quitting them.

The study encompassed 284,343 adults in the United Kingdom, aged 55 and older, between 2004 and 2016. Experts Noll Campbell, Richard Holden and Dr. Malaz Boustani all reiterated that more research is required to “clarify whether anticholinergic medications truly represent a reversible risk factor” for dementia.

Their editorial stated “Additionally, deprescribing trials can evaluate potential harms of stopping anticholinergic medications, such as worsening symptoms of depression, incontinence, or pain, as well as the potential unintended increase in acute health care utilization. With little evidence of causation, the next steps for research on anticholinergic medications in older adults must improve knowledge of the effect of deprescribing interventions on cognitive outcomes and important safety outcomes such as symptom control, quality of life, and health care utilize. We propose deprescribing research as a high priority.”

Dr. Douglas Scharre, director of the division of cognitive neurology at Ohio State University Wexner Medical Center in Columbus said, “I spend a lot of my time in the memory disorder clinic seeing geriatric patients and taking people off medications, mostly ones that have anticholinergic properties, and many times there can be another drug out there that has less anticholinergic impact or is non-anticholinergic that may work. Some of the medications that they list in the study may be quite critical and important and are well worth the person taking for their seizures or their psychosis, and so it’s a risk-benefit discussion. So have a conversation with your doctor.”