Everyday drugs raise the risk of dementia

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Researchers from the United States, Britain and Ireland found anticholinergic drugs, which are often prescribed as antidepressants and for incontinence, may increase risk for dementia, based on analysis of 27 million prescriptions given to 40,770 people over age 65 who were diagnosed with dementia between April 2006 and July 2015.

Amitriptyline was in the news in February, named as the most effective of the antidepressants in a study.

Rob Howard, professor of old age psychiatry at University College London has a different opinion, arguing that "It is possible that use of some of these drugs may have actually been to treat the very earliest symptoms of Alzheimer's disease, which can be associated with low mood and lower urinary tract infections, many years before the development of dementia". Studies involving community living residents or those in nursing homes have also suggested that anticholinergic drugs are linked with long-term cognitive decline or dementia.

In England, 1.5 to two million people are likely to be taking anticholinergics for depression, Parkinson's and bladder problems. The drugs had already been shown to affect short-term cognition.

A total of 14,453 (35%) cases and 86,403 (30%) controls were prescribed at least one anticholinergic drug with an ACB score of 3 during this period. Speaking to the BBC, Dr Ian Maidment from Aston University said it was important for people not to panic.

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"Middle aged and older populations are increasingly taking multiple drugs, but the potential adverse events of long term use are not well understood", the researchers wrote.

Patients with concerns should continue taking their medications until they can talk with their doctor, researchers say.

Anticholinergic drugs function by blocking the effects of acetylcholine, a chemical released by nerve cells to send signals to other nerves and muscles.

"While there are important advantages to research that uses the rich data held in medical records, we know that less than 70 per cent of people with dementia receive a formal diagnosis, and this study may not tell the whole story".

Long-term use of some anticholinergic medications are associated with an increased risk of dementia - according to a new study led by the University of East Anglia (UK).

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Patients who took anticholinergics for more than a year had around a 30 per cent increased risk of dementia, researchers said. And they said it was noticed 15 to 20 years before diagnosis.

Professor Chris Fox from East Anglia, one of the authors, thinks doctors should de-prescribe. "It's a long-term effect so don't suddenly stop taking medication". Not taking the medications could have serious consequences, he said. "These findings will be carefully evaluated, as with any study, to determine whether they have any implications for the safe use of anticholinergic medicines", he said.

Findings of the study have been disclosed in the worldwide peer-reviewed medical journal - the BMJ, which titled as 'Anticholinergic Medication and Risk of Dementia: Case-control Study'.

The researchers also caution that patients should always consult with their physicians before changing any medication regimen.

"We don't know exactly how anticholinergics might cause dementia". "Specifically, for most highly anticholinergic drugs, non-pharmacological and pharmacological alternatives are available and should be considered", they conclude.

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