These findings are definitely practice-changing and could lead doctors to dramatically curtail use of anticholinergic drugs"
- Rita F. Redberg, MD, editor of JAMA Internal Medicine
Professor Carol Coupland and researchers at the University of Nottingham's paper on anticholinergic drugs and dementia was the 2nd most viewed paper online across all the JAMA journals (September 1, 2018, and August 31, 2019) with 236,898 views. Paper:
View the news in JAMA https://jamanetwork.com/journals/jama/fullarticle/275628
This nested case-control study involving people aged 55 years or older found a dose-response association between dementia and any type of anticholinergic, a broad group of drugs that include some antihistamines, antidepressants, antipsychotics, and medications for gastrointestinal and bladder disorders.
Analyzing 284 343 cases and controls from a British general practice database, researchers found an approximately 50% increased dementia risk for people with the highest cumulative anticholinergic exposure. This category was defined as more than 1095 daily doses at the minimum effective dose recommended for older people in a 10-year exposure period. That’s equivalent to more than 3 years’ daily use of a single strong anticholinergic medication at the minimum effective dose.
Other types of drugs, as well as nonpharmacologic approaches, exist for all the conditions treated with anticholinergic medications, and the study suggests that substituting them could prevent up to about 10% of dementia prevalence.
Previously in the news: Commonly-prescribed drugs could increase the risk of dementia