Common Class of Drugs Linked to Dementia, Even When Taken 20 Years Before Diagnosis

Well, this is certainly a bit unnerving. The opposite side of the coin of exercising to remain healthy and prevent illness is taking medication once you become ill. Here are two widely used drugs that may have dire consequences on the patient years later.

Summary: Researchers have identified a link between anticholinergic medications, including antidepressants and incontinence drugs, and an increased risk of developing dementia later in life. Source: Regenstrief Institute.

The largest and most detailed study of the long-term impact of anticholinergic drugs, a class of drugs commonly prescribed in the United States and United Kingdom as antidepressants and incontinence medications, has found that their use is associated with increased risk of dementia, even when taken 20 years before diagnosis of cognitive impairment.

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An international research team from the US, UK and Ireland analyzed more than 27 million prescriptions as recorded in the medical records of 40,770 patients over age 65 diagnosed with dementia compared to the records of 283,933 older adults without dementia.

The researchers found greater incidence of dementia among patients prescribed anticholinergic antidepressants, anticholinergic bladder medications and anticholinergic Parkinson’s disease medications than among older adults who were not prescribed these drugs.

Dementia increased with greater exposure to anticholinergic medications.

“Anticholinergic Medication and Risk of Dementia: Case-control Study” is published in BMJ (formerly the British Medical Journal) an international peer-reviewed medical journal.

“Anticholinergics, medications that block acetylcholine, a nervous system neurotransmitter, have previously been implicated as a potential cause of cognitive impairment,” said Regenstrief Institute and Indiana University Center for Aging Research investigator Noll Campbell, PharmD, MS, a co-author of the new BMJ study. “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.” Dr. Campbell is also an assistant professor of pharmacy practice at Purdue University College of Pharmacy.

“These findings make it clear that clinicians need to carefully consider the anticholinergic burden of their patients and weigh other options,” said study co-author Malaz Boustani, M.D., MPH, a Regenstrief Institute and IU Center for Aging Research investigator. Dr. Boustani is the founder of the Indiana Clinical and Translational Science Institute’s IU Center for Health Innovation and Implementation Science and the Richard M. Fairbanks Professor of Aging Research at IU School of Medicine.

“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,” Dr. Boustani said.

The study, which was led by the University of East Anglia and funded by the Alzheimer’s Society, both in the UK, utilized data from the Clinical Practice Research Datalink which includes anonymized diagnosis, referral and prescription records for more than 11 million patients from 674 primary care practices across the UK. The data is broadly representative of the UK population in terms of age, sex and ethnicity.

“This research is really important because there are an estimated 350 million people affected globally by depression. Bladder conditions requiring treatment are estimated to affect over 13 percent of men and 30 percent of women in the UK and US,” said study lead researcher George Savva, PhD, visiting researcher at University of East Anglia’s School of Health Sciences.

“We don’t know exactly how anticholinergics might cause dementia,” said study co-author Chris Fox, MD, professor of clinical psychiatry at UEA’s Norwich Medical School and a consultant psychiatrist. “Further research is needed to understand possible reasons for this link. In the meantime, I strongly advise patients with any concerns to continue taking their medicines until they have consulted their doctor or pharmacist.”

Study co-author Ian Maidment, PhD, senior lecturer in clinical pharmacy at Aston University in the UK, said: “With many medicines having some anticholinergic activity, one key focus should be de-prescribing. Clinical staff, patients and carers need to work together collaboratively to limit the potential harm associated with anticholinergics.”

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8 Comments

Filed under antidepressants, cognition, cognitive decline

8 responses to “Common Class of Drugs Linked to Dementia, Even When Taken 20 Years Before Diagnosis

  1. Mary

    Is not better to enjoy a healhier life while you are younger than permanently worry about your old age?

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    • I think if you pay attention to your food and exercise when you are young, you can enjoy your youth and extend your old age. I don’t consider that worrying about old age. I think not to consider your old age is kind of like the ostrich with its head buried in the sand. You are going to get old some day. I am 78 and feel healthier than when I was working and 55 years old.

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      • Mary

        I do know about diet and exercise. What worries me more than bodily health is my memory which is getting patchy. My memory is not any worse than others but it is a shadow of what it used to be.
        My son keeps reminding me that I am no longer in my twenties, kind of frustrating. I am cheerful and friendly speak to strangers all the time it is a
        Scottish trait. My son lives in Stockholm and keeps telling me not to speak to people that I don’t know. I worked in shops all my life and it was essential to speak to the customers.
        I enjoy reading your blogs..

        Liked by 1 person

      • Thanks for your kind words, Mary. Much appreciated. Are you getting enough exercise? Don’t forget that walking is an excellent form of exercise even though most jocks don’t think much of it. If you are familiar with my blogs, you know that you need to be eating intelligently, moving, not smoking and getting enough sleep. That seems to be touching all the bases for me. I am just another old guy trying to stay on this side of the ground. I’m not a doctor. Best of luck with your efforts!

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      • Mary

        Tony I know all the theory about keeping to a healthy diet and amount of exercise I should be taking. Nothing wrong with my mind only my willpower.

        Liked by 1 person

      • Identifying the problem gets you halfway to the solution.

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  2. Mary

    I think for someone in her eighties I am doing well. I am independent ,eat pretty sensibly and am teetotal. ( mainly because I can stagger when I am absolutely sober ). I look on the bright side of things and find pleasure in small things.

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