Anticholinergic drugs are widely used for dozens of conditions, minor and major.
They are used for a broad array of conditions, from allergies and colds to high blood pressure and urinary incontinence.
Some of these medications require a prescription, while others can be purchased over the counter.
They work by blocking acetylcholine — a type of neurotransmitter or chemical messenger known to be critical for memory function — from binding to receptors on certain nerve cells.
A recent study at the University of California San Diego and elsewhere found that these anticholinergic drugs may be linked to an increased risk of cognitive decline, particularly in older adults at a higher risk for Alzheimer’s disease (AD).
The study is published in Neurology. One author is Lisa Delano-Wood, Ph.D.
In the study, the team tested 688 adults. None of the participants displayed cognitive or memory problems at the beginning of the study.
Each reported whether they were taking anticholinergic drugs.
One-third were taking such medications, with an average of 4.7 anticholinergic drugs per person. Participants were given annual comprehensive cognitive tests for up to 10 years.
The researchers found that cognitively normal study participants who were taking at least one anticholinergic drug at baseline were 47% more likely to develop mild cognitive impairment (MCI), often a precursor to dementia such as AD.
They also looked at whether people had biomarkers for AD in their cerebrospinal fluid, such as certain types of proteins, or a well-known genetic risk factor for AD.
They found that participants with AD biomarkers who were taking anticholinergic drugs were four times more likely to develop MCI than persons lacking biomarkers and not taking the drugs.
The researchers believe this interaction between anticholinergic drugs and Alzheimer’s risk biomarkers acts in a ‘double hit’ manner.
In the first hit, Alzheimer’s biomarkers indicate that pathology has started to accumulate in and degenerate a small region called the basal forebrain that produces the chemical acetylcholine, which promotes thinking and memory.
In the second hit, anticholinergic drugs further deplete the brain’s store of acetylcholine. This combined effect most significantly impacts a person’s thinking and memory.
The findings suggest that reducing anticholinergic drug use before cognitive problems appear may be important for preventing future negative effects on memory and thinking skills, especially for people at greater risk for Alzheimer’s disease.
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