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Exposure To Some Anticholinergic Drugs Increases Risk Of Dementia: Study

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A study has suggested that the risk of dementia is stronger in older adults on the use of anticholinergic drugs, highlighting the importance of reducing exposure to anticholinergic drugs in middle-aged and older people.

Anticholinergic drugs work by blocking the action of a neurotransmitter called acetylcholine. This inhibits nerve impulses responsible for involuntary muscle movements and various bodily functions.

These drugs can treat a variety of conditions, including allergies, cold, higher blood pressure, overactive bladder and chronic obstructive pulmonary disorder.

A new study in the journal JAMA Internal Medicine indicates that the use of anticholinergic drugs could be increasing the risk of dementia by as much as 50 percent.

The study found that there was nearly a 50 percent increase in dementia risk in people who had taken more than 1,000 daily doses of an anticholinergic drug within a ten-year period, compared to people who had never taken the drugs.

This is equivalent to three years' daily use of a single strong anticholinergic medication at the minimum effective dose recommended for older people.

The study involved analyzing data on 284,343 adults in the UK, aged 55 year or older, over a 12-year period. The researchers determined each person's anticholinergic exposure using prescription details.

The researchers found that dementia risk was strongest for the anticholinergic antidepressants, bladder antimuscarinics, antipsychotics, and antiepileptic drugs. Associations were also stronger in cases diagnosed before the age of 80 years and in cases diagnosed with vascular dementia rather than with Alzheimer disease.

However, the study found no significant increases in dementia risk associated with antihistamines, gastrointestinal antispasmodics, antimuscarinic bronchodilators, antiarrhythmics, or skeletal muscle relaxants.

According to the study, the odds of dementia increased from 1.06 among those in the lowest anticholinergic exposure category to 1.49 among those in the highest exposure category, compared with having no prescriptions for anticholinergic drugs.

According to the researchers, they found only an association between anticholinergic drugs and dementia risk, not a casual relationship.

"However, if this association is causal, the population-attributable fractions indicate that around 10% of dementia diagnoses are attributable to anticholinergic drug exposure, which would equate, for example, to around 20,000 of the 209,600 new cases of dementia per year in the United Kingdom," they noted.

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