Increased dementia risk found from common drugs that treat depression, more

Lynn Cook
April 27, 2018

Dr. Ian Maidment of Aston University in Birmingham, England advised patients not to panic, the BBC said.

The researchers, led by the University of East Anglia, stop short of claiming that the drugs cause dementia. "Physicians should review all the anticholinergic medications - including over-the-counter drugs - that patients of all ages are taking and determine safe ways to take individuals off anticholinergic medications in the interest of preserving brain health". Dr Campbell is an investigator with the Regenstrief Institute and Indiana University Center for Aging Research and is an assistant professor with Purdue University College of Pharmacy in the United States.

Other scientists said the study was well done but cautioned that it did not prove the drugs were a cause of dementia.

Anticholinergic drugs are created to block the neurotransmitter acetylcholine in the central or peripheral nervous system, and have diverse actions, dependent on the site, the researchers explain. Patients who took anticholinergics - which work by blocking a key neurotransmitter in the body called acetylcholine - for more than a year had around a 30 peer cent increased risk of dementia, researchers said. Studies involving community living residents or those in nursing homes have also suggested that anticholinergic drugs are linked with long-term cognitive decline or dementia. Stronger anticholinergic drugs can sometimes have powerful side-effects, though, including memory loss and confusion, and in the past, they've been linked to dementia, although not conclusively.

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After comparing the dementia patients' records with 283,933 older adults who did not have dementia, the researchers found a 30 percent increased risk of developing the condition after taking the drugs. "But we know from other research that people with long-term health conditions really only take their medication as prescribed around half of the time - the other half, people either take more or less of their medication or not at all".

Tricyclic antidepressants such as amitriptyline, which are also prescribed for pain and to help with sleeping, and one of the SSRI class, paroxetine (also known as Seroxat), are implicated by the largest ever study to look at this possible risk.

Dr Parastou Donyai, associate professor of social and cognitive pharmacy at the University of Reading, said: "This type of study imagines that patients actually take their drugs as they were prescribed for them". The association between anticholinergic drug use and dementia was even evident for drug exposure 15-20 years before diagnosis, "suggesting that reverse causation or confounding with early dementia symptoms are less likely explanations for the effect", the team writes.

The study was carried out by researchers from the United Kingdom and the U.S. and looked at data for just under 41,000 patients aged 65-99 with a dementia diagnosis and just under 300,000 controls without dementia, making this the largest study of its kind to date. However, other such medications treating conditions such as hay fever or stomach cramps were not linked to dementia. This risk increased by three percentage points among those who had used anticholinergics for more than one year, they said.

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Experts on dementia and Alzheimer's disease urged patients to be cautious about the results of the study, the BBC said.

"More than 50 million people worldwide are affected by dementia and this number is estimated to be 132 million by 2050", Savva said in a statement. "Don't stop taking your medication".

"This study shows that some anticholinergics may cause long-term harm in addition to short-term harm". "Further research is needed to understand possible reasons for this link".

To examine these associations, researchers used multiple conditional logistic regression to evaluate patients with a new diagnosis of dementia and compared their anticholinergic drug use 4-20 years before diagnosis; they were then matched to a control group without dementia.

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