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Dementia risk linked to these commonly prescribed drugs in a new study



A study published in JAMA Internal Medicine on Monday suggests that the association is most pronounced for certain classes of anticholinergics, particularly antidepressants, bladder antifungal, antipsychotics and antiepileptic drugs.
Researchers wrote in the study that "there was an almost 50% increased likelihood of dementia associated with a total anticholinergic exposure of more than 1,095 daily doses over a 10-year period, which corresponds to an older adult, at least A strong anticholinergic drug daily for three years does not expose.
"The study is important because it provides an increasing body of evidence that strong anticholinergic drugs are associated with dementia risk over the long term," said Carol Coupland, a professor of medical statistics in primary care at the University of Nottingham in the United Kingdom and first author of the study.

"It is also highlighted which types of anticholinergic drugs are the strongest associations. This is important information for physicians to consider if they should prescribe these drugs, "she said, adding," This is an observational study so no firm conclusions can be drawn as to whether these anticholinergics cause dementia.

It is recommended that these medicines are not discontinued without consulting the doctor, as this can be harmful.

  Conventional over-the-counter medicines can damage your brain.
The study included the analysis of data on 284,343 adults in the United Kingdom aged 55 years and older between 2004 and 2016. The data came from QResearch, a large database of anonymised patient records.

The researchers identified the anticholinergic exposure of each adult The researchers found that the most commonly prescribed anticholinergic antidepressants, drugs for the treatment of dizziness, motion sickness or vomiting and bladder are antimuscarinics, for example, for the treatment of overactive bladder.

The researchers also studied exactly who was diagnosed with dementia, and found that 58,769 patients e had dementia diagnosis.

The researchers found no significant increase in dementia risk associated with antihistamines, skeletal muscle relaxants, gastrointestinal anti-spasmodics, antiarrhythmic drugs or antimuscarinic bronchodilators.

The researchers found that the likelihood of having dementia of 1.06 among those with the lowest anticholinergic exposure was 1.49 among those with the highest exposure compared to nonprescription anticholinergics.

The study had some limitations, including the fact that some patients may not have taken the prescribed medication as indicated, so that anticholinergic exposure was possible was misclassified. The researchers found only a link between anticholinergics and dementia risk, not a causal relationship.

"However, if this relationship is causal, population-based proportions suggest that around 10% of dementia diagnoses are due to exposure to anticholinergics, which would be equivalent to about 20,000 of the 209,600 new cases of dementia in the UK each year," they said Researchers in the study.

Since the study has only one connection, further research is needed to "elucidate" whether anticholinergic drugs really represent a reversible risk factor for dementia, "wrote experts Noll Campbell, Richard Holden, and Dr. Malaz Boustani in an editorial in addition to the new study published in JAMA Internal Medicine.

Damage due to the discontinuation of anticholinergics, such as the worsening of depression symptoms, incontinence or pain as well as the potential Uninte "Considering the low evidence of causes, the next steps for research must be anticholinergic Drugs in Older Adults Improve Knowledge on the Impact of Prescribing Interventions, "Campbell, Holden, and Boustani wrote in the editorial, cognitive outcomes and important safety outcomes such as symptom control, quality of life, and health care utilization they wrote. "We suggest that prescribing research be a high priority."

It is well known that anticholinergics and confusion or memory problems are related, but the new study examined this relationship over a long period of time, said Drs. Douglas Scharre. Director of the Department of Cognitive Neurology at Wexner Medical Center, Ohio State University, Columbus, who was not involved in the study.

He encouraged all patients who might have questions about this association to speak with their doctors.

I spend much of my time in the clinic for memory problems with geriatric patients and discontinuing medication, mostly with anticholinergic properties, and often there is another drug that has less anticholinergic effect or may not be anticholinergic work, "said Scharre.

"Some of the medications you list in the study can be very critical and important and are worth the person taking them for their seizures. It's a risk-benefit discussion," she added He added, "So talk to your doctor."


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