Anticholinergic medications are commonly used in patients to treat bladder problems or depression. However, a new study carried out by scientists at the University of East Anglia has suggested that these drugs could lead to an increased risk of dementia. Although they are used to treat the symptoms of mental health conditions, there are concerns that they could cause mental declines later in life.
This type of medication is known for having the potential to cause problems with memory function and attention, and medical professionals are aware that it can cause declines in older patients. But the new research has shown the risk could be most serious than previously believed. The scientists found that taking anticholinergic medications for depression could increase the risk of dementia for up to 20 years after taking it.
Dr George Savva from UEA’s School of Health Sciences and the lead author of the study: “We found that people who had been diagnosed with dementia were up to 30 per cent more likely to have been prescribed specific classes of anticholinergic medications. The association with dementia increases with greater exposure to these types of medication.”
It was also noted that the risks of developing dementia would also depend on the individuals lifestyle, genetics and the type and duration of the treatment. For example, they found that, on average, someone with a 10% risk of developing dementia in the next 15 year would see their risk increase to 13% after taking the medication for a year, or “one in 33 chance of getting dementia you would otherwise not have got.”
The greatest risks were seen in patients who were taking drugs like oxybutynin and tolterodine, which are used for bladder disorders; amitriptyline and paroxetine, which are prescribed for depression; and benztropine and procyclidine which are used to treat Parkinson’s disease.
In light of this study, the scientists say that doctors should remain aware of the guidelines that are in place, which includes taking older patients off these drugs as well as being cautious when patients are on multiple prescriptions. They also need to remain careful when prescribing them for depression. It’s estimated that one in five patients taking medication for depression are on an anticholinergic drug.
Dr Ian Maidment from Aston University, the lead pharmacist on the study said: “This study shows that some anticholinergics may cause long-term harm in addition to short-term harm. With many different medicines having at least some anticholinergic activity, one focus should be de-prescribing. Doctors, nurses and pharmacists need to work with older people and their carers to ensure that they only take medication if the benefits clearly outweigh the harms.”
Rob Howard, professor of old age psychiatry at University College London, who was not involved in the study added: “This is a large and very well conducted epidemiological study showing an 11 per cent increase in the incidence of dementia in people who have been treated with drugs that include, as a side-effect, strong action against the neurotransmitter acetylcholine in the preceding four to 20 years. We already know that anticholinergic drugs can precipitate the presentation of people with early dementia, but this is the first convincing demonstration that the use of the drugs many years before dementia diagnosis might increase risk.”