Antidepressants, incontinence drugs linked to dementia in research

27 April, 2018, 01:17 | Author: Joshua Bennett
  • Science has linked anticholinergic drugs with cognitive impairment and an increased risk of dementia

The drugs, which are regularly prescribed as antidepressants and to treat incontinence, increase dementia risk even when taken 20 years before diagnosis of cognitive impairment.

Savva's group studied the medical records of 40,770 patients, ages ≥65, who were diagnosed with dementia, comparing them with 283,933 controls.

The focus now should be on "de-prescribing", he insisted, adding: "Doctors, nurses and pharmacists need to work with older people and their carers to ensure that they take medication only if the benefits clearly outweigh the harms".

Results from the nested case-control study, including more than 40,000 patients with dementia, showed a significant correlation between use of anticholinergic drugs and dementia, but only for certain types of this class of drugs. Are you concerned your medication could be increasing your risk of dementia?

Anticholinergic drugs help treat depression, as well as other ailments such as bladder conditions or Parkinson's. Conversely, the use of gastrointestinal drugs (ACB score 1 or 3) and cardiovascular drugs (ACB score 1) was linked to a minor reduction in dementia risk.

Some anti-depressants and bladder medications may heighten the risk of developing dementia, according to new researchers who are warning doctors to be cautious when prescribing drugs.

For drugs with an anticholinergic cognitive burden (ACB) score of 3, the adjusted OR increased from 1.07 (95% CI 1.02-1.12, P 0.01) for patients with 14 to 89 daily doses of these drugs to 1.31 (95% CI 1.22-1.41, P 0.01) for those with over 1,460 daily doses. Not taking the medications could have serious consequences, he said.

"We already have strong evidence that anticholinergics cause confusion and in the short-term will potentially worsen the symptoms of dementia", said co-author Ian Maidment, PhD, of Aston University in Birmingham, England, in a statement. However, after a new study written by researchers at the University of East Anglia, we now face a new question: what should we do?

Frequently prescribed anticholinergic drugs include procyclidine (Kemadrin) for Parkinson's; tolterodine, oxybutynin, and solifenacin (Vesicare) for urological conditions such as overactive bladder or incontinence; and amitriptyline, dosulepin, and paroxetine for depression. He told the BBC that compared with the risk posed by leading an unhealthy lifestyle, the potential risk of an anticholinergic drug contributing to the onset of the disease was "quite small". Levels of acetylcholine are known to be significantly lower in people with Alzheimer's disease, the most common cause of dementia in older adults, according to the Mayo Clinic.

"Many of the treatment options for these conditions involve medication with anticholinergic effects. It's a long-term effect so don't suddenly stop taking medication".

The researchers also caution that patients should always consult with their physicians before changing any medication regimen. This type of study imagines that patients actually take their drugs as they were prescribed for them. Nevertheless, the team claims, the findings are signficant enough to warrant reduced prescribing anticholinergics, where possible "With many medicines having some anticholinergic activity, one key focus should be de-prescribing", states study co-researcher Ian Maidment, Ph.D., senior lecturer in clinical pharmacy at Aston University in the United Kingdom.


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