Common drugs can cause cognitive difficulties (dementia)

Posted On July 23, 2019 by Editor

July 18, 2019, Kaiser Health News

An estimated 1 in 4 older adults take anticholinergic drugs — a wide-ranging class of medications used to treat allergies, insomnia, leaky bladders, diarrhea, dizziness, motion sickness, asthma, Parkinson’s disease, chronic obstructive pulmonary disease and various psychiatric disorders.

Older adults are highly susceptible to negative responses to these medications. Since 2012, anticholinergics have been featured prominently on the American Geriatrics Society Beers Criteria list of medications that are potentially inappropriate for seniors.

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Common side effects include dizziness, confusion, drowsiness, disorientation, agitation, blurry vision, dry mouth, constipation, difficulty urinating and delirium, a sudden and acute change in consciousness.

Unfortunately, “physicians often attribute anticholinergic symptoms in elderly people to aging or age-related illness rather than the effects of drugs,”

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Since then several studies have noted an association between anticholinergics and a heightened risk of dementia. In late June, this risk was highlighted in a new report in JAMA Internal Medicine that examined more than 284,000 adults age 55 and older in Britain between 2004 and 2016.

The study found that more than half of these subjects had been prescribed at least one of 56 anticholinergic drugs. (Multiple prescriptions of these drugs were common as well.) People who took a daily dose of a strong anticholinergic for three years had a 49% increased risk of dementia.

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These findings don’t constitute proof that anticholinergic drugs cause dementia; they show only an association.

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Attention is now turning to how best to wean older adults off anticholinergics, and whether doing so might improve cognition or prevent dementia.

Researchers at Indiana University’s School of Medicine hope to answer these questions in two new studies, starting this fall…

Advice for Older Adults

• Ask your physician about the risks versus benefits of taking these (and any) medications.
• Don’t stop taking medication cold turkey or on your own. Work with your physician and/or medical provider.
• Don’t assume that over the counter drugs are safe for your brain (or for anything). Ask your physician about how all the medications you take could affect your brain (or you in general).
• According to Dr. Steven DeKosky, deputy director of the McKnight Brain Institute at the University of Florida, “Finally, doctors should “not give anticholinergic medications to people with any type of dementia,” “This will not only interfere with their memory but is likely to make them confused and interfere with their functioning.”

Discuss everything with your physician/medical provider.