By Lauren Burgess
Scientists have found a possible connection between anticholinergic drugs and a higher risk of dementia.
In a recent study published in JAMA Internal Medicine, it was suggested that certain classes of anticholinergic drugs–such as certain antidepressant, antipsychotic, and antimuscarinic medications–are tied to a significantly higher risk of dementia.
Researchers claimed that “there was nearly a 50% increased odds of dementia” associated with exposure of more than 1,095 daily doses of anticholinergic medication within a ten year period.
Carol Coupland, a professor of medical statistics in primary care at the Univerisity of Nottingham and first author of the study stated, “The study is important because it strengthens a growing body of evidence showing that strong anticholinergic drugs have long term associations with dementia risk.”
The observational study used QResearch data of 284,343 adults in the United Kingdom 55 and older, between 2004 and 2016.
Researchers look at each adult’s exposure to anticholinergic drugs and found that the risk for dementia increased from 1.06 among those exposed to low anticholinergic medication to 1.49 among those who had a higher exposure, compared to those who were not prescribed anticholinergic medication.
Because the study only shows an association, not a causal relationship, more research is needed to “clarify whether anticholinergic medications truly represent a reversible risk factor” for dementia”, according to experts Noll Campbell, Richard Holden, and Dr. Malaz Boustani, in an editorial published alongside the study.
“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 utilization. We propose deprescribing research as a high priority,” they wrote.
“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,” said Dr. Douglas Scharre, Director of the Division of Cognitive Neurology at the Ohio State University Wexner Medical Center. “So have a conversation with your doctor.”
