A significant scientific study has raised concerns about commonly prescribed medications that may heighten the risk of dementia. Research suggests that regular use of certain widely-prescribed drugs—used to treat bladder conditions, Parkinson's disease, and depression—could substantially increase the likelihood of developing dementia later in life.
Study Findings
Conducted by experts at the University of Nottingham and funded by the National Institute for Health Research (NIHR), the study revealed that patients aged 55 and over who took strong anticholinergic medication daily for three years or more faced nearly a 50% greater risk of developing dementia. The findings were published in the JAMA Internal Medicine journal.
What Are Anticholinergic Drugs?
Anticholinergic medications assist in the contraction and relaxation of muscles by blocking acetylcholine, a chemical responsible for transmitting signals throughout the nervous system. Doctors prescribe these drugs to treat a wide variety of conditions, including chronic obstructive pulmonary disease, bladder problems, allergies, gastrointestinal disorders, and symptoms associated with Parkinson's disease.
Expert Commentary
The Alzheimer's Society commented: "Our own researchers have already shown a strong link between anticholinergic drugs and risk of dementia. This study builds on this information, showing that long-term, high-dose use increases risk of some dementias, particularly vascular dementia." They added: "A shortcoming of this type of study is that from this information we can't rule out whether the diseases that cause dementia might have already begun in the brains of people involved before they started taking these drugs."
Current guidelines for doctors recommend that anticholinergic drugs should be avoided for frail older people due to their impact on memory and thinking. However, doctors should consider these new findings for all middle-aged and older people, as long-term use could raise the risk of dementia.
Research Details
The research, led by Professor Carol Coupland from the University's Division of Primary Care, examined the medical records of 58,769 patients diagnosed with dementia and 225,574 patients without a dementia diagnosis. All patients were aged 55 and over and registered with UK GPs contributing data to the QResearch database between 1 January 2004 and 31 January 2016. The dementia patients had an average age of 82, and 63% were women. Each dementia case was matched to five control patients of the same age, sex, and general practice.
Specific Drugs Linked to Risk
The study's findings pointed to an elevated risk of dementia associated with anticholinergic drugs as a whole, and specifically with anticholinergic antidepressants, antipsychotic drugs, antiparkinsons drugs, bladder drugs, and epilepsy drugs, once other dementia risk factors had been taken into account. No elevated risks were identified for other categories of anticholinergic drugs examined in the study, including antihistamines and gastrointestinal medications.
Recommendations for Patients
These findings add to the growing body of evidence suggesting that physicians should exercise caution when prescribing certain drugs with anticholinergic properties. It is crucial, however, that patients currently taking such medications do not suddenly stop without medical guidance, as this could prove far more detrimental to their health. Anyone with concerns is strongly advised to consult their doctor to carefully weigh up the advantages and disadvantages of their current treatment.
Professor Coupland said: "Our study adds further evidence of the potential risks associated with strong anticholinergic drugs, particularly antidepressants, bladder antimuscarinic drugs, anti-Parkinson drugs and epilepsy drugs. The risks of this type of medication should be carefully considered by healthcare professionals alongside the benefits when the drugs are prescribed and alternative treatments should be considered where possible." She added: "We found a greater risk for people diagnosed with dementia before the age of 80, which indicates that anticholinergic drugs should be prescribed with caution in middle-aged people as well as in older people."
Dementia Symptoms to Watch For
The Alzheimer's Society lists six common symptoms of dementia:
- Memory loss – problems recalling things that happened recently
- Difficulty organising thoughts – struggling to make decisions, solve problems, or follow steps
- Changes in mood or personality – becoming unusually anxious, irritable, or withdrawn
- Problems with communication – difficulties following conversations or struggling to find the right words
- Problems with vision – problems judging distances or perceiving object edges
- Getting confused about time or place – losing track of the time or date, or becoming confused about where they are
Should you have concerns about yourself or a loved one, check your symptoms by visiting the Alzheimer's Society website or calling their Dementia Support Line.
