Researchers have long found a possible link between anticholinergic drugs and an increased risk of dementia. A study published in the JAMA Internal Medicine Monday magazine suggests that the link is strongest for some classes of anticholinergic drugs – especially antidepressants, bladder antimuscarinics, antipsychotics and antiepileptic drugs. Researchers wrote in the study that "there were almost 50% increased odds for dementia" in conjunction with a total anticholinergic exposure of more than 1,095 daily doses within a 10-year period, which corresponds to an older adult taking a strong anticholinergic medication daily for at least three years, compared to no exposure. "The study is important because it strengthens a growing body of evidence that strong anti-cholinergic drugs have long-term association with dementia," said Carol Coupland, Professor of Medical Statistics in the University of Nottingham, UK, and first author of the e-study. "It also highlights the types of anticholinergic drugs that have the strongest compounds. This is important information for doctors to know when considering whether to prescribe these drugs," she said, adding "this is an observation study so no concrete conclusions are made. can be drawn on whether these anticholinergic drugs cause dementia. "She said people taking these medications are recommended not to stop them without first affording their doctor because it can be harmful. The study involved analyzing data on 284,343 adults in the UK, aged 55 and over, between 2004 and 201
Researchers have long found a possible link between anticholinergic drugs and an increased risk of dementia.
A study published in the JAMA Internal Medicine Monday magazine suggests that the link is strongest for some classes of anticholinergic drugs – especially antidepressants, bladder antimicrobial agents, antipsychotics and antiepileptics.
Researchers wrote in the study that "there were nearly 50% increased odds for dementia" associated with a total anticholinergic exposure of more than 1,095 daily doses within a 10-year period, which is equivalent to an older adult taking a strong anticholinergic drug daily for at least three years, compared to no exposure.
"The study is important because it strengthens a growing evidence that strong anticholinergic drugs have long term compounds with dementia," says Carol Coupland, a professor of medical statistics in the primary care of the University of Nottingh, in the UK and first author of the study.
"It also highlights what types of anticholinergic drugs have the strongest compounds. This is important information for doctors to know when considering whether to rewrite these drugs, she says and adds." This is an observation study, so that no concrete conclusions can be drawn about whether these anticholinergic drugs cause dementia. "She said that people taking these medications are recommended not to stop them without first affording their physician, as it could be harmful.
The study meant analysis of data on 284,343 adults in the UK, 55 years and older, between 2004 and 2016. The data came from QResearch, a large database of anonymized health records.
The researchers identified each adult's anticholinergic exposure based on data on their prescriptions. the most commonly prescribed anticholinergic drugs were antidepressants, drugs to treat dizziness, stir reading sickness or vomiting and antimuscarinic drugs in the bladder, such as treating overactive bladder.
The researchers also looked at who was diagnosed with dementia and found that 58,769 of the patients had a dementia diagnosis.
The researchers found no significant increases in demensal risk associated with antihistamines, skeletal muscle relaxants, gastrointestinal antispasmodics, antiarrhythmics or antimuscarinic bronchodilators according to data, but compounds were among other classes of anticholinergic drugs.
The researchers found that the odds of dementia increased from 1.06 among those who had the lowest anticholinergic exposure to 1.49 among those who had the greatest exposure compared to having no prescription for anticholinergic drugs.  The study had some limitations, including that some patients may not have taken their prescribed medication according to direction, so anticholinergic exposure levels could have been unclassified. The researchers found only a link between anticholinergic drugs and dementia, not a causal relationship.
"If this association is causal, the population-dependent fractions indicate that about 10% of dementia diagnoses are attributable to anticholinergic drug exposures, which would, for example, correspond to about 20,000 of the 209,600 new dementia diseases in the UK in the UK," the researchers wrote in the study. .
Since the study shows only one association, more research is needed to "clarify whether anticholinergic drugs really represent a reversible risk factor" for dementia, wrote experts Zero Campbell, Richard Holden and Dr. Malaz Boustani in an editorial published together with the new study in JAMA Internal Medicine.
"In addition, repressive trials can evaluate potential damages to stopping anticholinergic drugs, such as worsening symptoms of depression, incontinence or pain, as well as potentially unacceptable end-of-life increases in acute health utilization," Campbell, Holden, and Boustani wrote in the editors.
"With little evidence of causal link, the next step for anticholinergic drug research in older adults must improve knowledge of the effect of prescribing interventions on cognitive results and important safety outcomes such as symptom control, quality of life and health utilization," they wrote. "We propose depreciation of research as a high priority."
It has been well known that anticholinergic agents and confusion or memory issues are linked, but the new study examined this compound over a long period of time, Dr. Douglas Scharre, Head of the Division of Cognitive Neurology at the Wexner Medical Center in Ohio, who was not involved in the study.
He encouraged all patients who might have questions about this association to talk to their doctors.  "I spend a lot of my time in the memory disorder clinic and see geriatric patients and take people off medication, mostly those who have anticholinergic properties and many times there may be another drug out there that has less anticholinergic effect or is non-anticholinergic. can work, Scharre says.
"Some of the medications they list in the study can be quite critical and important and are well worth the person receiving their seizures or inheriting psychosis, and so it is a risk-benefit discussion , "he added." So have a conversation with your doctor. "