Cognitive decline can range from mild cognitive impairment to dementia, a form of decline in abilities severe enough to interfere with daily life. Alzheimer’s disease is the most common form of dementia.
Memory and other thinking problems have many possible causes, including depression, an infection, or medication side effects.
Sometimes, the problem can be treated, and cognition improves. Other times, the problem is a brain disorder, such as Alzheimer’s disease, which cannot be reversed.
In a study from the University of California San Diego, scientists found that a class of drugs used for many health conditions may be linked to an increased risk of mild thinking and memory problems.
These drugs, called anticholinergic drugs, are used for high blood pressure, motion sickness, urinary incontinence, overactive bladder, and Parkinson’s disease.
The link is very strong in people who have genetic risk factors for Alzheimer’s disease.
There are approximately 100 such drugs in widespread use, with some requiring a prescription and many others that may be purchased over the counter.
In the study, the team tested 688 people with an average age of 74 who had no problems with thinking and memory skills at the start of the study.
The participants reported if they were taking any anticholinergic drugs within three months of the start of the study at least once a week for more than six months.
They took cognitive tests once a year for up to 10 years.
One-third of the participants were taking anticholinergic drugs, with an average of 4.7 anticholinergic drugs taken per person. Metoprolol, atenolol, loratadine, and bupropion were the most common.
The team found that cognitively normal people taking at least one anticholinergic drug were 47% more likely to develop mild cognitive impairment, which can be a precursor to dementia, over the next decade than people who were not taking such drugs.
They also found that people with biomarkers for Alzheimer’s disease in their cerebrospinal fluid who were taking anticholinergic drugs were 4 times more likely to later develop mild cognitive impairment than people who were not taking the drugs and did not have the biomarkers.
Similarly, people who had genetic risk factors for Alzheimer’s disease and took anticholinergic drugs were about 2.5 times as likely to later develop mild cognitive impairment than people without the genetic risk factors and who were not taking the drugs.
The findings suggest that reducing the use of anticholinergic drugs before people develop any cognitive problems may be an important way to prevent the negative consequences of these drugs on thinking skills, especially for people who have an elevated risk of developing Alzheimer’s disease.
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The study was conducted by Lisa Delano-Wood et al and published in Neurology.
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