New research from the University of Nottingham, supported by the National Institute for Health Research (NIHR), has found that long-term use of strong anticholinergic drugs may raise the risk of developing dementia by nearly 50%. The study focused on adults over 55 who had been taking these medications daily for three years or more.
Anticholinergic drugs work by blocking acetylcholine, a key neurotransmitter in the nervous system, thereby affecting muscle contractions and nerve signals. They are commonly prescribed for a variety of conditions including bladder disorders, Parkinson’s disease, depression, gastrointestinal issues, allergies, and chronic obstructive pulmonary disease (COPD).
While short-term effects like confusion and memory problems are known, this study aimed to clarify whether prolonged usage affects dementia risk. Led by Professor Carol Coupland, the team analyzed the health records of 58,769 dementia patients and 225,574 controls aged 55 and older, using data from UK general practices collected between 2004 and 2016.
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Their findings align with previous research from the University of Washington, which tracked nearly 3,500 older adults for seven years. That study found a 54% increased risk of dementia among those taking anticholinergic drugs for the equivalent of three years or longer compared to brief use.
Particularly, increased dementia risk was associated with anticholinergic antidepressants, antipsychotics, Parkinson’s disease medications, bladder drugs, and epilepsy treatments. Conversely, no elevated risk was found for anticholinergic antihistamines or gastrointestinal medications.
Professor Tom Dening of the Centre for Dementia emphasized the need for cautious prescribing: “Doctors should carefully weigh the risks and benefits of these drugs. Patients shouldn’t stop medication abruptly but should consult their healthcare providers to evaluate alternatives.”
The study highlighted a stronger association in individuals diagnosed with dementia before age 80, suggesting middle-aged adults should also be prescribed these drugs with caution. Alzheimer’s Society reinforced these conclusions, noting that while causation isn’t definitively established, the findings underline the importance of careful medication management and regular review.
In summary, the evidence urges healthcare professionals to consider less risky alternatives when possible and to monitor long-term anticholinergic use closely to mitigate potential dementia risks.