The study found that those with genetic risk factors for Alzheimer’s disease are particularly susceptible to these issues, and overall patients with no cognitive issues were revealed to be 47% more likely to develop a mental impairment if they are taking at least 1 anticholinergic medication.
“Our findings suggest that reducing the use of anticholinergic drugs before people develop any cognitive problems may be an important way to prevent the negative consequences of these drugs on thinking skills, especially for people who have an elevated risk of developing Alzheimer’s disease,” study author Lisa Delano-Wood from the University of California, San Diego says in a press release.
Anticholinergic drugs have a wide range of uses being used to treat serious diseases and common health issues such as motion sickness, urinary incontinence, overactive bladders, high blood pressure, and to help manage Parkinson’s disease. The most common medications in the anticholinergic drug class include but are not limited to atenolol, bupropion, loratadine, and metoprolol.
688 patients with an average age of 74 were examined in this study, reporting that none of the patients had any trouble with thinking or memory at the beginning of the decade-long review. The study analyzed cognitive tests taken by the participants once a year throughout the study period.
According to the study authors, those on anticholinergics are usually taking more than one, and overall one-third of the study participants were found to be taking some form of this class of medication with the average using 4-5 anticholinergic drugs. Out of the 230 taking these drugs 51% went on to develop mild cognitive impairments, and among those not taking any of these drugs 42% went on to eventually have these problems.
The authors report still arriving at their 47% risk determination even after adjusting for factors such as depression, the number of medications taken, and history of cardiac problems, adding that higher exposure to anticholinergic medications increased the risk factor.
The authors also report that the majority of patients are likely taking higher doses that may be needed, with 57% of the study participants being reported to be taking twice the minimum recommended dosage and 18% taking four times that amount.
“This is of course concerning and is a potential area for improvement that could possibly lead to a reduction in cases of mild cognitive impairment,” says Delano-Wood.
Those with risk factors for Alzheimer’s disease in their cerebrospinal fluid were reported to be four times more likely to be affected by anticholinergic medications, and those with other genetic risk factors for Alzheimer’s disease were reported to be 2.5 times more likely to develop mild cognitive impairments, according to the researchers.
It was noted that the study was limited by the patient sample size and that only one third were taking this class of drugs. But the researchers added that other studies have found the number of adults taking anticholinergics is closer to 70%. While their findings point to possible issues with these types of medications, the authors recommend speaking with a doctor or pharmacist before suddenly stopping the use of any prescription anticholinergic medication.
