Some antidepressants and bladder drugs linked to dementia risk in study

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A new study has linked common antidepressants and incontinence medications to increased risk of dementia - even if the drugs are taken 20 years before diagnosis.

Researchers at The University of East Anglia in the United Kingdom studied the medical records of more than 40,000 patients aged 65 and older with dementia, and compared them to records of more than 283,000 people without the ailment.

Results from the nested case-control study, including more than 40,000 patients with dementia, showed a significant correlation between use of anticholinergic drugs and dementia, but only for certain types of this class of drugs.

Research director Dr. Carol Routledge with the Alzheimer's Research UK said that researchers that started this study should continue looking more into the connection between "anticholinergics and dementia risk, and researchers will need to build on these findings in future studies".

Dementia was linked to increasing exposure to antidepressant, urological and antiparkinson drugs.

Using anticholinergic medications over depression promotes higher dementia risks, confirmed by the researchers from the University of East Anglia after analyzing the patients who had always been suffering through Parkinson's disease, depression or bladder conditions and prescribed with heavy dosage of certain anticholinergics. There was a positive association for antidepressants with an ACB 1 score and dementia risk; no other drugs with an ACB score of 1 had this association. It could be that these medications are being prescribed for very early symptoms indicating the onset of dementia.

Experts emphasise that patients should not stop taking the drugs, as their benefits may outweigh any risk.

Several studies have reported associations between use of anticholinergics and future cognitive decline and dementia, but it is not clear whether this is due to the drugs themselves or the underlying conditions for which they were prescribed.

"Not everyone with the conditions highlighted in the study will be prescribed these particular drugs, and the researchers did not find a link between dementia risk and anticholinergic drugs used to treat allergies, stomach problems or muscle spasms".

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The new study is among the largest of its kind and adds to the existing literature linking long-term anticholinergic use with dementia, according to Dr. Clive Ballard, executive dean of University of Exeter Medical School, who was not involved in the research.

"While there are important advantages to research that uses the rich data held in medical records, we know that less than 70 per cent of people with dementia receive a formal diagnosis, and this study may not tell the whole story".

"We don't know exactly how anticholinergics might cause dementia".

"Many of the treatment options for these conditions involve medication with anticholinergic effects".

"We studied patients with a new dementia diagnosis and looked at what anticholinergic medication they were prescribed between four and 20 years prior to being diagnosed".

"They need to consider the risk of long-term cognitive effects, as well as short-term effects, associated with specific drugs when weighing up risks and benefits".

"Doctors and patients should therefore be vigilant about using anticholinergic medications". "Specifically, for most highly anticholinergic drugs, non-pharmacological and pharmacological alternatives are available and should be considered", they conclude.

"As a patient, if you are concerned about it, go and speak to your doctor or your pharmacist".

"In the last 20 years, the number of older individuals taking five or more medicines has quadrupled", said Dr Ian Maidment, senior lecturer in clinical pharmacy at Aston University.