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These common drugs increase the risk of dementia by 50%



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Anticholinergics are medications prescribed for overactive bladder, depression, Parkinson's disease or epilepsy. According to a British study, people over age 55 who get the most raise the risk of dementia by almost 50%.

In France, about 900,000 people suffer from Alzheimer's disease and 200,000 new cases of dementia are diagnosed each year. If age, heredity, but also thehypertension, O diabetes, may play a role in Alzheimer's dementia, one may wonder whether certain drugs promote the disease.

O anticholinergics are molecules which oppose the action of theacetylcholine, one neurotransmitter of the nervous system. These medications are prescribed for different conditions: for lung problems, allergies, problems related to bladder, gastrointestinal disorders, Parkinson's disease… But anticholinergics have short-term side effects, causing memory loss and confusion. They also have long-term effects on brain ?

To find out, researchers at the University of Nottingham analyzed data from more than 58,000 people suffering from insanityand 225,000 witnesses. The participants, aged over 55 years, were on average 82 years of age.

In the period from one to eleven years diagnosis of dementia, 57% of the patients took anticholinergics compared to 51% of the controls. On average, people who had a diagnosis of dementia received six prescriptions for these drugs, compared with four for controls. The most prescribed drugs were antidepressants, anti-dizziness and antimuscarinic drugs for overactive bladder problems.

Anticholinergics increase the risk of dementia

The results of the study published in the journal JAMA Internal Medicine Overall, there is a risk of dementia related to anticholinergic drugs: for those who consumed the most, the risk of dementia increased by 49% compared to those who never consumed it.

Specifically, the drugs involved in this risk were antidepressants, antipsychotics, drugs against Parkinson's disease,epilepsy or bladder disorders. On the other hand, there appears to be no risk associated with takingantihistamines or medications for gastrointestinal disorders.

The association between anticholinergics and dementia was stronger when the disease was diagnosed before age 80. If the cause-and-effect relationship is demonstrated, it would mean that about 10% of dementias diagnosed in the UK are caused by anticholinergics! The study suggests that these drugs should be prescribed with caution in middle-aged and elderly people.

On a university press releaseTom Dening, who participated in this paper, explained that despite these risks, "It is important that patients who take these drugs do not stop them abruptly because this can be much more harmful." If patients have concerns, they should discuss this with their physician to discuss the pros and cons of the treatment they receive.

What to remember

  • Anticholinergics are prescribed drugs in many cases: Parkinson's, depression, epilepsy, allergies, incontinence …
  • They have short-term side effects with memory loss.
  • Some anticholinergics increase the risk of long-term dementia.

Drugs that cause the onset of Alzheimer's disease

Article Inserm published on February 16, 2006

Potentially anticholinergic drugs may cause moderate impairment of certain cognitive (or intellectual) abilities in the elderly, particularly affecting reaction time, immediate or delayed memory, or language. This is the conclusion reached by Karen Ritchie and her team (Inserm Research Team 361) diseases of the nervous system: epidemiological and clinical research ", Montpellier).

Details of these results are published online by British Medical Journal.

Anticholinergic medications are commonly prescribed in the elderly to treat conditions such as urinary incontinence, Parkinson's disease or certain psychiatric disorders. These compounds, some of which may also be available without a prescription, are potential inhibitors of the transmission of chemical messages or neurotransmitters in the brain, such asacetylcholine, particularly involved in memory or learning.

Marie-Laure Ancelin and Sylvaine Artero of Karen Ritchie's team accompanied 372 people over the age of 60 who did not have dementia. These people were questioned about their current health problems, past and drug use. His intellectual performance was also tested.

About 10% of the respondents in this sample were taking anticholinergic medications for at least one year. Drug users had poorer cognitive abilities compared to non-users. Eighty percent had moderate intellectual impairment (compared to 35% in the non-consumer group).

The administration of anticholinergics has been shown to be an important contributing factor in the prediction of cognitive deterioration. In fact, in view of other risk factors Known cognitive impairment (age, sex, educational level, hypertension), the risk of deterioration of cognitive abilities remains 5 times greater in people who consume. On the other hand, the analyzes did not reveal, with a decline of 8 years, a significant difference in the risk of developing dementia between users and non-users of anticholinergics.

Faced with these results, the researchers estimate thatIt is important that prescribers of these drugs be warned about their possible side effects..

In addition, the authors point out the absurd situation that could lead to poor consideration of these results. In fact, identifying changes in cognitive abilities often leaves suspicion of incipient dementia and thus prompts the physician to prescribe a treatment for this dementia. In this case, people with moderate anticholinergic deficiencies would receive pro-cholinergic drugs to counteract the effects of anticholinergics.

In conclusion, the researchers suggest that physicians precisely determine the status of the elderly person who has a moderate impairment of intellectual ability (whether or not they use anticholinergics) before considering treatment for dementia.

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