Anticholinergic medication use best avoided in older adults
medwireNews: Brain imaging techniques have shown negative effects of anticholinergic medications on brain metabolism and size in cognitively healthy adults, providing further insight into the increased risk of cognitive decline associated with these medications.
The effects were greatest for those taking drugs with the most anticholinergic activity, the researchers note in JAMA Neurology.
Among 451 cognitively healthy individuals aged an average of 73 years, 60 were taking at least one medication with medium or high anticholinergic activity. These participants scored lower on memory tests for immediate recall and on the Trail Making Test Part B and had lower executive function composite scores than the participants not taking such medications.
Use of these drugs was also associated with significantly reduced glucose metabolism in the hippocampus and there were significant reductions in total cortical volume and temporal lobe cortical thickness, while lateral ventricle and inferior lateral ventricle volumes were increased.
The researchers report a 2.47-fold increased risk of progression to mild cognitive impairment and/or Alzheimer’s disease among patients taking anticholinergic medications, with individuals positive for amyloid beta at greatest risk.
Lead researcher Shannon Risacher (Indiana University School of Medicine, Indianapolis, USA) said in a press release: “Given all the research evidence, physicians might want to consider alternatives to anticholinergic medications if available when working with their older patients.”
By Lucy Piper
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