Anticholinergic Drugs Raise Mortality Risk in Dementia Patients

by Angela Mohan on Nov 6 2020 3:54 PM

Anticholinergic Drugs Raise Mortality Risk in Dementia Patients
Anticholinergics, the drugs that block the action of a neurotransmitter named acetylcholine, could raise the risk of mortality in dementia patients, as per the study in Aging & Mental Health.//
People with dementia are more likely to be taking medications for various diseases and/or illnesses than people without dementia. Dr Alan McMichael, Researcher from the Centre for Public Health at Queen’s University and first author on the paper, said: “The aim of this study was to examine the risk of mortality associated with anticholinergic use among those with dementia. We looked specifically at people in Northern Ireland as this had never been studied before.

“We already know there is a link between anticholinergic use and a higher risk of developing dementia or cognitive impairment, but little is known about the link between anticholinergic use and whether they influence mortality rates among people with dementia.”

Tthe researchers looked at data from the Enhanced Prescribing database for 25,418 people who were prescribed at least one dementia management medication between 2010 and 2016.

Statistical models were used to assess the effects of anticholinergic medication on survival, and multilevel model regression determined what demographic characteristics affect anticholinergic burden.

Higher anticholinergic burden in dementia people was linked to higher mortality rates. The researchers found of the 25,418 people with dementia, only 15 per cent had no anticholinergic burden.

Diazepam (42 per cent) and risperidone (18 per cent) were found to be the two most commonly prescribed drugs and respiratory and urological drugs significantly increased mortality rates among people with dementia. People with dementia living areas in with low levels of deprivation had lower anticholinergic burden.

Dr Bernadette McGuinness, Researcher from the Centre for Public Health at Queen’s, Consultant Geriatrician at the Belfast Health and Social Care Trust and senior author on the paper, said: “Our study has shown that drugs with a high anticholinergic burden increase mortality in people with dementia.

These findings are important for the people with dementia, their families, carers and healthcare professionals world-wide.

“We hope this discovery will pave the way for better understanding of the effect of anticholinergic drugs and leads to better treatment options for people with dementia. Further research should address the unfavorable prognosis of people living with dementia in highly deprived areas to improve their life expectancy.”

Seamus McErlean, Commissioning Lead for Dementia, Health and Social Care Board, said: “This is an important piece of research, the findings of which significantly enhance our understanding of pharmaceutical regimes in dementia care. The lessons from it need to be disseminated and acted upon while at the same time continuing to promote and support further research into the possible causes of the condition, a cure and best care practice in dementia care.”

The study was funded by Atlantic Philanthropies, The Executive Office and The Department of Health as part of a wider Dementia eHealth and Data Analytics Pathfinder Programme. The Health and Social Care Board (HSCB) has been tasked with delivering this programme which has separate Workstreams, five focusing on eHealth and three on Data Analytics.

This Programme has two related strands, focused on building the capacity to collect and use dementia data to improve the planning and commissioning of efficient, effective and value for money dementia services, and to create a platform that can be utilized to enable data driven care-planning solutions across the health and social care system.

This Queen’s study is one of 14 studies being commissioned using dementia data. Data analytics research into dementia has the potential to rapidly improve the understanding of the progression of dementia and help assess the effectiveness of interventions and treatments in Northern Ireland.