A group of commonly used medicines may be linked to a greater risk of memory and thinking problems in older adults, according to research involving hundreds of people.
The drugs are known as anticholinergic medicines and are used for a wide range of health problems.
Anticholinergic medicines can be prescribed for conditions such as bladder problems, Parkinson’s disease and some other illnesses. Some medicines used for allergies, sleep problems and other everyday complaints can also have anticholinergic effects, including products that may be available without a prescription.
These drugs work by reducing the activity of acetylcholine, a chemical messenger used by the brain and nervous system. Acetylcholine has an important role in attention, learning and memory, which is why researchers have long been interested in whether medicines that block it could affect brain health.
Researchers led by Lisa Delano-Wood at the University of California, San Diego studied 688 older adults whose average age was about 74. None of the participants had problems with thinking or memory when they entered the study.
The researchers recorded whether participants regularly used medicines with anticholinergic effects. Regular use was defined as taking the medicine at least once a week for more than six months.
The participants then completed tests of memory and thinking each year for as long as 10 years. About one-third were taking at least one medicine with anticholinergic effects during the study.
The results showed a clear association. Older adults taking these medicines had a 47% greater risk of developing mild problems with thinking and memory than people who were not taking them.
These early problems are sometimes called mild cognitive impairment. A person with this condition has more difficulty with memory or thinking than would normally be expected for their age, although they may still be able to carry out most everyday activities independently.
Mild cognitive impairment does not always progress to dementia. However, it can be an early warning sign, and some people with it later develop Alzheimer’s disease or another form of dementia.
The researchers found an even stronger association among participants who already had biological signs connected with Alzheimer’s disease. Those with certain Alzheimer’s-related biomarkers who also took anticholinergic medicines were about four times more likely to develop mild cognitive problems than people without those factors.
Genetics appeared to matter as well. Participants carrying a genetic variant associated with increased Alzheimer’s risk were about 2.5 times more likely to develop cognitive problems when they also used anticholinergic medicines.
The findings do not prove that these medicines directly caused the memory decline. People who need particular medications may have other health conditions that influence their risk, and observational studies cannot completely separate all of these factors.
Still, the results add to concerns about the total anticholinergic burden carried by some older adults, especially those taking several medicines. As people age, their bodies may also process medicines differently, making regular medication reviews particularly important.
The study was published in Neurology, the medical journal of the American Academy of Neurology. The researchers suggested that reducing unnecessary use of medicines with anticholinergic effects could potentially be one way to lower the risk of future cognitive problems, particularly among people already at higher risk of Alzheimer’s disease.
That does not mean people should stop taking their medicines on their own. Some medications are important for controlling serious conditions, and suddenly stopping them can be harmful.
Older adults who are concerned about memory changes or the medicines they take can ask a doctor or pharmacist for a medication review. A healthcare professional can check whether a medicine has anticholinergic effects, whether the dose remains appropriate and whether a safer alternative may be available.
Protecting brain health often involves many factors, including managing blood pressure, staying physically active, getting enough sleep and treating medical conditions properly. Reviewing long-term medicines can be another useful part of that broader approach.
If you care about dementia, please read studies about Vitamin B9 deficiency linked to higher dementia risk, and flavonoid-rich foods could help prevent dementia.
For more health information, please see recent studies that cranberries could help boost memory, and how alcohol, coffee and tea intake influence cognitive decline.
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