Is your medication increasing your dementia risk?

21 May 2018
A new study has indicated that certain medicines commonly prescribed for conditions like bladder infections and depression may lead to an increased risk of dementia.

Looking after your health is one of the most important aspects of enjoying a happy and fulfilling retirement, so it's vital for older people to make sure they are always receiving the most appropriate treatment for any conditions they might have.

For many, this involves a longer-term reliance on certain medications to help manage chronic conditions, allowing them to carry on living life unimpeded by troublesome or debilitating symptoms. These prescriptions can often have a transformative impact on older people's quality of life, but at the same time, long-term medication use can also carry a number of risks that users need to be aware of before committing to a course of treatment.

This issue has recently hit the headlines with the release of a new study linking certain types of medicine with an elevated risk of dementia - a finding that could lead many older patients to seek alternative forms of treatment for their conditions.

The role anticholinergic drugs may play in the onset of dementia

The study, published in the British Medical Journal and led by the University of East Anglia, has uncovered evidence that some anticholinergic medications - which function by blocking a key neurotransmitter in the body called acetylcholine - may be linked to a higher dementia risk when taken over a prolonged period of time.

Researchers studied the medical records of 40,770 patients aged 65 and over who had been diagnosed with dementia, as well as 283,933 people without dementia, with more than 27 million prescriptions analysed. It represents the largest and most detailed study to examine the long-term impact of anticholinergic use in relation to dementia.

The results showed that anticholinergic antidepressants were linked with dementia, even when taken up to 20 years before a diagnosis, with examples of frequently prescribed therapies of this kind including amitriptyline, dosulepin and paroxetine. It was also revealed that a number of therapies for bladder conditions - for example, tolterodine, oxybutynin and solifenacin - could be linked to dementia, as well as Parkinson's disease therapies such as procyclidine.

It is worth noting that this does not apply to all anticholinergic therapies, nor does it necessarily mean these drugs actually cause dementia; indeed, the scientists noted that depression and bladder issues are among the early signs of dementia, meaning it is possible that these drugs are simply used more commonly by those with early-stage symptoms of the condition. Nevertheless, the findings may prompt a new approach to the long-term use of anticholinergic drugs.

Chris Fox, consultant psychiatrist and professor of clinical psychiatry at the University of East Anglia's Norwich Medical School, said: "While the associations are moderate, given the high incidence of dementia, they reflect a potentially important risk to patients.

"Doctors and patients should therefore be vigilant about using anticholinergic medications. They need to consider the risk of long-term cognitive effects, as well as short-term effects, associated with specific drugs when weighing up risks and benefits."

How can older people reduce their dementia risk?

The publication of this new study is likely to prompt many older people to ask themselves whether they are doing all they can to keep their brains healthy and stave off the risk of dementia for as long as possible.

Fortunately, most of the steps that retirees can take to minimise their chances of developing dementia are simple lifestyle changes that can be put into practice immediately. The most obvious is to stay as physically healthy and active as possible, which means taking part in aerobic exercise, maintaining a healthy diet, and avoiding damaging habits such as smoking and drinking too much alcohol.

Looking after your mental health can also be hugely helpful in preventing dementia, as well as increasing your overall quality of life. Take the time to challenge yourself, take on new hobbies, study new subjects and explore your passions; additionally, do everything you can to remain socially active, and keep in regular contact with friends and family.

Finally, for those who might be concerned about anticholinergic medications, or any long-term course of therapy they are receiving, it's important not to simply refuse to continue treatment in response to these worries. Instead, have a conversation with your doctor, who'll be able to provide you with the educated advice you need to feel confident you are receiving the best possible care.

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