'Current guidelines for doctors say that anticholinergic drugs should be avoided for frail older people due to their impact on memory and thinking, but doctors should consider these new findings for all middle aged and older people as long-term use could raise the risk of dementia'.
Anticholinergic drug exposure was assessed using prescription information over a complete period of 10 years from 1 to 11 years before diagnosis of dementia or the equivalent dates in control patients, and was compared between the two patient groups.
Over 10 years, 56.6% of dementia patients and 51% of controls were prescribed at least one anticholinergic drug, a median of six prescriptions in dementia patients and four in controls - mainly antidepressant, anti-vertigo, and antimuscarinic drugs to treat overactive bladder. However, it is also mentioned that the findings in JAMA Internal Medicine do not really indicate that there is a direct risk, and neither is there an urgency for people who take the drug to come off it.
"However", he warns, "it's important that [people] taking medications of this kind don't just stop them abruptly, as this may be much more harmful". Additional funding was provided by the Faculty of Medicine and Health Sciences Research Board, University of Nottingham.
And they added the associations appeared to be stronger in people diagnosed with dementia before they were 80, suggesting the drugs played a greater role for them.
Doctors often prescribe anticholinergic drugs for a variety of ills.
The study, carried out by experts from the University of Nottingham and funded by the NIHR School for Primary Care Research, found that there was almost a 50% increased risk of dementia among patients aged 55 and over who had used strong anticholinergic medication daily for three years or more. For instance, it only shows an association and not a casual relationship between anticholinergic drugs and increased dementia risk. In fact, some of these drugs may have been prescribed to treat very early symptoms of the neurological disease.
The researchers found certain types of anticholinergic drugs showing the strongest connection with increased risk of dementia. "That is serious info for physicians to know when interested in whether or to now not prescribe these medicines", she stated, including "this is an observational glance so no agency conclusions will likely be drawn about whether or now not these anticholinergic medicines trigger dementia".
"The risks of this type of medication should be carefully considered by healthcare professionals alongside the benefits when the drugs are prescribed and alternative treatments should be considered where possible".
"With little evidence of causation, the next steps for research on anticholinergic medications in older adults must improve knowledge of the effect of deprescribing interventions on cognitive outcomes and important safety outcomes such as symptom control, quality of life, and health care utilization", they wrote. If [people] have concerns, then they should discuss them with their doctor to consider the pros and cons of the treatment they are receiving.
Experts said the findings had "enormous implications" for millions of Britons, with half of middle-aged people taking one of the medications.
This is not the first analysis to show a link between anticholinergics and dementia: an observational study previous year showed that associations between anticholinergic medications and dementia persisted up to 2 decades after exposure.