Seniors face high risk of Alzheimer’s, dementia from
Senior citizens often take anticholinergic drugs,
which are commonly prescribed for a wide range of common health
17, 2015 – There is nothing that strikes fear in the hearts of senior
citizens more than the risk of dementia, and Alzheimer’s disease in
particular. A recent study found, however, a significantly increased
risk for developing dementia, including Alzheimer’s disease from taking
commonly used medications with anticholinergic effects, which are taken
frequently by older adults, often unknowingly. They even include
nonprescription medicines like Benadryl.
But the stern warning about anticholinergics
significantly increasing this risk among seniors failed to get the
attention it probably deserves.
Senior citizens often take anticholinergic drugs,
which are commonly prescribed for a wide range of health conditions.
Among the most widely used anticholinergics are antihistamines,
including over-the-counter allergy and cold preparations and sleeping
aids used regularly by elderly people.
“Older adults should be aware that many medications
- including some available without a prescription, such as
over-the-counter sleep aids - have strong anticholinergic effects,” said
Shelly Gray, PharmD, MS, the first author of the report.
And the greater the use of the drugs, the higher
the potential risk, according to the researchers.
“Efforts to increase awareness among health care
professionals and older adults about this potential medication-related
risk are important to minimize anticholinergic use over time,” they said
in their conclusion.
“But of course, no one should stop
taking any therapy without consulting their health care provider,” said
Dr. Gray, who is a professor, the vice chair of curriculum and
instruction, and director of the geriatric pharmacy program at the
UW School of Pharmacy.
“Health care providers should regularly review their older patients’
drug regimens—including over-the-counter medications—to look for chances
to use fewer anticholinergic medications at lower doses.”
Anticholinergics are prescribed for many health
conditions in older people, including overactive bladder, depression and
even just seasonal allergies. Some are available over the counter and
are often used as sleep aids. These medications block a neurotransmitter
– acetylcholine - in the brain and body and may cause such side effects
as impaired cognition, especially in older people. This side effect was
previously thought to be reversible once the person stopped taking the
However, the researchers show that these
medications may have a lasting impact.
By analyzing records and data from the
NIA-supported Group Health/University of Washington Adult Changes in
Thought (ACT) study for drugs prescribed over 10 years to 3,434 seniors
age 65 and older, they calculated cumulative exposure to drugs with
strong anticholinergic effects.
Prospective population-based cohort study using
data from the Adult Changes in Thought study in Group Health, an
integrated health care delivery system in Seattle, Washington. We
included 3434 participants 65 years or older with no dementia at study
Initial recruitment occurred from 1994 through 1996
and from 2000 through 2003. Beginning in 2004, continuous replacement
for deaths occurred. All participants were followed up every 2 years.
Data through September 30, 2012, were included in these analyses.
During a mean follow-up of 7.3 years, 797
participants (23.2%) developed dementia. Seventy-nine percent of these
(637) developed Alzheimer's disease).
The analysis showed that 78 percent of ACT
participants used anticholinergics at least once in 10 years.
The higher the use of anticholinergics, the higher
the risk of dementia, regardless of whether the drugs had been taken
recently or years ago.
The findings suggest that physicians treating older
people should prescribe alternatives to anticholinergics, when possible,
or lower doses of the drugs. More studies are needed to determine to
what extent stopping anticholinergics can reduce the risk of developing
“If providers need to prescribe a
medication with anticholinergic effects because it is the best therapy
for their patient,” Dr. Gray said. “They should use the lowest effective
dose, monitor the therapy regularly to ensure it’s working, and stop the
therapy if it’s ineffective.”
Robert Preidt, HealthDay, presents a more
laid back view of the research. -- “However, the study could
only point to an association between long-term or high-dose use
of these drugs and a higher risk of dementia, it could not prove
► List of reports and information about these drugs
at the U.S. government’s National Library of Medicine, Medline
Plus website –
are used to treat many medical problems such as sleeping
problems, stomach cramps, incontinence, asthma, motion sickness,
and muscle spasms. Side effects, such as confusion, can be
serious for a person with AD. These drugs should NOT be given to
a person with AD.
Bronchodilators are medications that relax the muscles that wrap
around your breathing tubes, allowing the tubes to become larger
and easier to breathe through. Types of bronchodilators include
Anticholinergic bronchodilators are inhaled medicines.
Anticholinergic effects happen
because some medications block the neurotransmitter called acetylcholine
in the brain and body, she explained. That can cause many side effects,
including drowsiness, constipation, retaining urine, and dry mouth and
The study used more rigorous
methods, longer follow-up (more than seven years), and better assessment
of medication use via pharmacy records (including substantial
nonprescription use) to confirm this previously reported link. It is the
first study to show a dose response: linking more risk for developing
dementia to higher use of anticholinergic medications.
And, it is also the first to
suggest that dementia risk linked to anticholinergic medications may
persist - and may not be reversible even years after people stop taking
“With detailed information on
thousands of patients for many years, the ACT study is a living
laboratory for exploring risk factors for conditions like dementia,”
said Dr. Gray’s coauthor
Eric B. Larson, MD, MPH.
“This latest study is a prime
example of that work and has important implications for people taking
medications—and for those prescribing medications for older patients.”
Dr. Larson is the ACT principal investigator, vice president for
research at Group Health, and executive director of Group Health
Research Institute (GHRI). He is also a clinical professor of medicine
at the UW School of Medicine and of health services at the
UW School of Public Health.
Some ACT participants agree to have
their brains autopsied after they die. That will make it possible to
follow up this research by examining whether participants who took
anticholinergic medications have more Alzheimer’s-related pathology in
their brains compared to nonusers.
University of Washington School of Pharmacy
Founded in 1894, the UW School of Pharmacy is
ranked #3 in the world according to Shanghai Jiao Tong University.
Follow the School of Pharmacy on
UW Medicine is part of the University of Washington. Its system
includes Harborview Medical Center, Northwest Hospital & Medical Center,
Valley Medical Center, UW Medical Center, UW Neighborhood Clinics, UW
Physicians, UW School of Medicine and Airlift Northwest. UW Medicine is
affiliated with Seattle Children’s, Fred Hutchinson Cancer Research
Center, the Veteran’s Affairs Healthcare System in Seattle, and the
Boise VA Medical Center. It shares in the ownership and governance of
the Seattle Cancer Care Alliance and Children’s University Medical
Group Health Research Institute
Group Health Research Institute does practical
research that helps people stay healthy. The Institute is the research
arm of Seattle-based
Group Health Cooperative, a consumer-governed, nonprofit health care
system. Founded in 1947, Group Health Cooperative coordinates health
care and coverage. Group Health Research Institute changed its name from
Group Health Center for Health Studies in 2009. The Institute has
conducted nonproprietary public-interest research on preventing,
diagnosing, and treating major health problems since 1983. Government
and private research grants provide its main funding. Follow Group
Health research on
Financial Relief for Volkswagen Diesel Owners
You may be eligible for money damages if you owned or leased one of these VW, Porsche or Audi vehicles.
In the major scandal of 2015, Volkswagen cheated you and the world. They rigged diesel emission controls so you, nor regulators, would know how much pollution their cars were adding to our environment.
They were caught and have reserved $7.3 billion to help "make it right" with victims.
If you owned or leased one of these vehicles, contact us now.
Janicek Law attorneys are actively pursuing these cases against VW. Do Not Wait...