The study was led by Professor Carol Coupland from the
University's Division of Primary Care and the findings of the research appear
in the journal
.
. From the observed findings, the team believes
that patients who used strong anticholinergic drugs daily for
had a nearly 50%
increased risk of dementia. The findings of the current study echo the results
of a similar study done in 2018.
Professor Tom Dening, Head of the Centre for Dementia at the
University of Nottingham and a member of the research study team, said:
"This study provides further evidence that doctors should be careful when prescribing certain drugs that have
anticholinergic properties. However, it's important that patients taking
medications of this kind don't just stop them abruptly as this may be much more
harmful. If patients have concerns, then they should discuss them with their
doctor to consider the pros and cons of the treatment they are receiving."
However, the study team caution that this is an
observational study and definite
conclusions cannot be drawn between the use of anticholinergic drugs and increased dementia risk and that
that in some cases, the drugs may have been prescribed for early symptoms of
dementia.
Takeaways
From Study
- Physicians should
prescribe strong anticholinergic agents with caution only after weighing the risk-benefit balance
- The observed risk
was most marked in
anticholinergic drugs prescribed to treat Parkinson's disease, depression and overactive bladder
- Whenever possible
alternative agents should be prescribed
- If
anticholinergics are still prescribed, regular patient reviews must be carried out
- Several cases of
dementia were diagnosed before 80 years suggesting that anticholinergics must be prescribed
with caution both in middle-aged as well as elderly
patients
- Should a causal relationship be proved between anticholinergic drugs and dementia, this would account for about 10% of
dementia diagnosis or nearly 20,000 of the 209,600 new cases of
dementia annually in the UK
- Around 10% of
dementia cases attributable to anticholinergic drugs is indeed a significant proportion along with
other modifiable risk factors including 5% for high blood pressure in
middle age, 3% for diabetes, 6.5% for a sedentary life and 14.5% for
smoking in later life.
In summary, long term prescription of anticholinergic
drugs to treat depression, overactive bladder or
Parkinson's disease may increase
dementia risk and doctors should prescribe these agents with caution or prefer
other alternatives to reduce patient's risk of dementia.
References : - Anticholinergic Drug Exposure and the Risk of Dementia doi:10.1001/jamainternmed.2019.0677
Source: Medindia