According to a new study, a group of researchers in the UK and US re-analysed data collected between 1991 and 1993 as part of a large ongoing MRC study into the decline of mental functioning in people over 65 to determine whether the use of anticholinergic drugs increases the cognitive impairment risk and death in older people.
Anticholinergic drugs block the chemical acetylcholine which is vital in the transmission of electrical impulses between nerve cells, also have an effect on concentration, memory and causes confusion. Drugs with anticholinergic effects are commonly used in many areas of medicine, eg, eye drops Timolol Maleate, warfarin for blood thinning, the painkiller Codeine, allergy tablets Piriton, incontinence drug Ditropan, the antidepressant Seroxat and the sleeping pill Nytol.
Researchers examined more than 80 drugs having anticholinergic effects and classified them with score into 3 groups : severe, moderate and mild based on potential harm. Drugs with a severe risk include Piriton, Nytol and Ditropan.
Researchers found that nearly half of the elderly patients in the study took 1 or more of these drugs, 4% were taking drugs with definite anticholinergic properties. The results showed that 20% of those taking drugs with a total score of 4 or more died by the end of the two-year study, compared with only 7% of those taking no anticholinergic drugs. Those taking several of the drugs had a 4% worse score in key tests to check the function of their brain. They concluded that the use of anticholinergic drugs increases the risk of cognitive impairment and mortality.
Critics say that the data were collected 20 years ago and may not reflect the current prescribing practice. Although the use of anticholinergic drugs was associated with increased death, it may have been influenced by some underlying conditions. It is important that people should not stop taking prescribed anticholinergic medication before speaking to their GP.
Source: Anticholinergic Medication Use and Cognitive Impairment in the Older Population: The Medical Research Council Cognitive Function and Ageing Study. Journal of the American Geriatrics Society. Article first published online: 24 JUN 2011 (full text via Athens)
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