Anticholinergic drugs may increase cognitive decline in older people

A study looked at the effects of taking a medication with anticholinergic properties on the annual change in thinking abilities of 870 Catholic nuns and clergy members who were an average of 75 years old. All of the participants were part of the Rush Religious Orders Study, an ongoing, longitudinal, clinical study of older people without dementia.

All of the participants underwent annual cognitive tests and reported their medication use for an average follow up period of eight years. During the study, 679 people took at least one medication with anticholinergic properties.

The study found those people who took anticholinergic drugs saw their rate of cognitive function decline 1.5 times as fast as those people who did not take the drugs.

“ Our findings point to anticholinergic drugs having an adverse impact on cognitive performance in otherwise normal, older people,” said study author Jack Tsao, at Uniformed Services University in Bethesda, Maryland. “ Doctors may need to take this into account before prescribing these commonly used drugs. ”

Tsao says more research is needed to determine the mechanism behind the rapid memory loss apparently associated with anticholinergic drugs and to identify which drugs, in particular, may be more likely to impair cognition.

Anticholinergics are a class of medications that inhibit parasympathetic nerve impulses by selectively blocking the binding of the neurotransmitter acetylcholine to its receptor in nerve cells. The nerve fibers of the parasympathetic system are responsible for the involuntary movements of smooth muscles present in the gastrointestinal tract, urinary tract, lungs, etc.
Anticholinergics are divided into three categories: antimuscarinic agents, ganglionic blockers, and neuromuscular blockers.

Source: American Academy of Neurology, 2008


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