Exposure to Anticholinergics May Increase Dementia Risk

Exposure to anticholinergic drugs is associated with an increased dementia risk, according to a study published online in JAMA Internal Medicine.

Carol A.C. Coupland, Ph.D., from the University of Nottingham in the United Kingdom, and colleagues examined whether exposure to anticholinergic drugs correlated with dementia risk in 58,769 patients with a dementia diagnosis and 225,574 matched controls aged 55 years or older. Cumulative anticholinergic drug exposure was calculated for 56 drugs with strong anticholinergic properties.

The researchers found that compared with no anticholinergic drug prescriptions in the one to 11 years before the date of diagnosis of dementia or the equivalent date in matched controls, the adjusted odds ratio for dementia increased from 1.06 in the lowest overall anticholinergic exposure category (total exposure of 1 to 90 total standardized daily doses [TSDD]) to 1.49 in the highest category (>1,095 TSDDs). For more than 1,095 TSDDs, there were significant increases in dementia risk for anticholinergic antidepressants (adjusted odds ratio [AOR], 1.29), antiparkinson drugs (AOR, 1.52), antipsychotics (AOR, 1.70), bladder antimuscarinic drugs (AOR, 1.65), and antiepileptic drugs (AOR, 1.39). The correlations were stronger for those diagnosed before 80 years of age.

"We propose deprescribing research as a high priority in the effort to reduce the burden of ADRD (Alzheimer disease and related dementias), while also learning about efficient and safe approaches to optimize medication use in older adults," write the authors of an accompanying editorial.

Two authors disclosed ties to the medical technology industry.

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