In the past, researchers identified a potential link between drugs taken by millions and Alzheimer’s. That relationship is being revisited this week, as a team of scientists are recommending that doctors consider “de-prescribing” if possible.

This recommendation is based on the largest study of its kind, addressing the potential harm of anticholinergics — a class of drugs that have been shown to impair memory.

Although medication effectively treat a wide range of conditions, researchers are concerned that many elderly patients are overprescribed. As stated by Dr Ian Maidment, a senior lecturer in clinical pharmacy, “In the past 20 years, the number of older individuals taking five or more medicines has quadrupled.

Do the risks of anticholinergics outweigh the benefits?

Large Study Finds a Link Between Anticholinergics and Dementia Risk

Anticholinergics include a fairly broad class of medications and are often prescribed for bladder issues, Parkinson’s, depression, and a number of other conditions. In fact, approximately one in five patients taking an antidepressant has been prescribed an anticholinergic — which may cause more harm than good.

The team studied records from 40,000+ people with dementia (65+ years of age), as well as nearly 300,000 without. What they found was that anticholinergic drugs were associated with an increased dementia risk. Looking at prescription records, they found that people who took these drugs four to 20 years earlier were more likely to have dementia.

It is important to note that not ALL anticholinergics were shown to influence a potential future dementia diagnosis. For example, antihistamines used to treat hay-fever, as well as gastrointestinal drugs did not influence risk. However, when prescribed drugs for bladder problems, depression, and Parkinson’s, the risk of dementia was 30 percent higher.

They explained that if someone over the age of 65 had a ten percent risk of developing dementia in the next 15 years (based on statistics), that risk would increase to 13 percent if they had taken anticholinergics for more than a year. That is fairly significant, especially because in some cases, these drugs were taken a decade or two prior.

The study did not prove that these medications cause dementia

At first, it appeared that the drugs were prescribed to those already in the early stages of dementia. This is because depression and urinary continence are early symptoms of dementia. However, the researchers noticed a dose-dependent response. The more of these pills taken over time, the greater the risk.

Although this study raises some important questions, it did not prove that these drugs cause dementia. Also, all patients are being warned that if you currently take these medications or any medications for that matter, do not discontinue using that drug without speaking to your doctor.

These findings were published in the BMJ.

The Difference Between Cholinesterase Inhibitors and Anticholinergics

Last week I discussed some of the drugs that are currently used to treat Alzheimer’s, including cholinesterase inhibitors. With only five medications approved for Alzheimer’s, this class of drugs can significantly improve a patient’s quality of life.

Although both cholinesterase inhibitors and anticholinergics impact acetylcholine, they are NOT the same. Cholinesterase inhibitors are cholinergic agonists, whereas anticholinergics are cholinergic antagonists.

• Cholinesterase inhibitors, such as Donepezil, increase cholinergic neuron activity and block the enzyme that breaks down acetylcholine. This means that these drugs increase the concentration of this neurotransmitter.
• Anticholinergics have the opposite effect, blocking the effects of acetylcholine. They work by blocking receptors to decrease involuntary movement and digestion.

For those currently taking anticholinergics, including the heavily prescribed tricyclic antidepressant known as amitriptyline, it is recommended that you discuss possible alternatives with your doctor.

If you are concerned about your brain health, BrainTest is the application for you. BrainTest is uniquely designed to screen for early changes in cognition associated with Alzheimer’s Disease, Dementia, and Mild Cognitive Impairment. BrainTest can be taken in the privacy of your own home, anonymously scored at our centralized scoring core-lab, and result videos delivered inside the application feature an explanation of your score from a Board Certified Physician. These results can be shared with your doctor to help start the conversation for early diagnosis.

In the meantime, your attention should be focused on key lifestyle variables. Refer to the following infographic to reduce your risk of Alzheimer’s and improve overall well-being.

Share this article with your loved ones and friends to help spread awareness about the relationship between common drugs and Alzheimer’s.