Beware of Common Anticholinergic Drugs ..UPDATE 1/25/2017

[alice]

Beware of Common Anticholinergic Drugs





MEDICATION MANAGEMENT:

Memory and thinking work by activating brain cells with acetyl-choline. Alzheimer's drugs boost acetyl-choline. Medicines for other conditions are often anti-cholinergic drugs, which lower acetyl-choline. From allergies to insomnia, these can spell big trouble for people with dementia. Learn which drugs to avoid and what to look out for.



Drugs widely prescribed to the elderly could be responsible for a decline in cognitive and physical function according to research from the University of East Anglia and the Regenstrief Institute.

A key report reveals that anti-cholinergic drugs -- which are used to treat conditions including asthma, high blood pressure, insomnia, dizziness and diarrhea -- could impact physical functions in elderly patients such as eating and getting dressed.



Up to half the UK's elderly population are prescribed at least one medication with anti-cholinergic properties. Other anti-cholinergic drugs are also sold over the counter without the need for a prescription.


These medications affect the brain by blocking a key neurotransmitter called acetylcholine. But they have been associated with side effects including dizziness, sedation, confusion, delirium, constipation and blurred vision.

Previous studies have shown a link between these drugs and cognitive impairment, but this study is the first to summarise evidence of a physical decline among the elderly.

The research team looked at 46 studies from around the world that included 60,944 patients who had taken anti-cholinergic medications for up to 10 years.

Lead researcher Dr. Chris Fox, from UEA's Norwich Medical School, said. "We examined the effect of anti-cholinergic medication on physical function over a large time frame spanning decades of research.



"This is the first research to show a significant decline in physical, as well as cognitive, function. This means patients could become less and less able to carry out everyday activities like walking around, feeding themselves, washing and getting dressed.

"This is likely due to the direct effect on cholinergic neurons compounded by an increase in the blood-brain permeability.

"We have also seen that the type of anti-cholinergic drug may be important, and more research needs to be done to ascertain which types are more dangerous than others.

"Further studies are also needed to establish whether the cognitive decline is definitely induced by these medications -- or the whether the diseases for which they are prescribed are a factor too.

"In the meantime, the prescription of these medications for people with dementia should be cautiously assessed, monitored and attempts made to reduce the burden whenever feasible. Clinicians should conduct regular reviews of the medication taken by their older patients, both prescribed and over the counter, and wherever possible avoid prescribing multiple drugs with anti-cholinergic effects."

The international research team included experts from the Regenstrief Institute and the Indiana University Center for Aging Research in the US, Aston University, the University of Aberdeen and the Norfolk and Norwich University Hospital in the UK.

Co-author Dr Noll Campbell, from the Regenstrief Institute, IU Center for Aging Research and Purdue University College of Pharmacy, said: "Anticholinergics, both over-the-counter and prescription medications, impact the lives of older adults in ways doctors, patients and their families may not realize.

See another article below....

[alice]

List of Anticholinergic Drugs..Will try and get that for you.



My husband was on diphenhydramine (Benadryl), two years before AD..alice



From Harvard Medical Blog....9/ 2016

In a report published in JAMA Internal Medicine, researchers offers compelling evidence of a link between long-term use of anticholinergic medications like Benadryl and dementia.

Anticholinergic drugs block the action of acetylcholine. This substance transmits messages in the nervous system. In the brain, acetylcholine is involved in learning and memory. In the rest of the body, it stimulates muscle contractions. Anticholinergic drugs include some antihistamines, tricyclic antidepressants, medications to control overactive bladder, and drugs to relieve the symptoms of Parkinson’s disease.

What the study found

A team led by Shelley Gray, a pharmacist at the University of Washington’s School of Pharmacy, tracked nearly 3,500 men and women ages 65 and older who took part in Adult Changes in Thought (ACT), a long-term study conducted by the University of Washington and Group Health, a Seattle healthcare system. They used Group Health’s pharmacy records to determine all the drugs, both prescription and over-the-counter, that each participant took the 10 years before starting the study. Participants’ health was tracked for an average of seven years. During that time, 800 of the volunteers developed dementia. When the researchers examined the use of anticholinergic drugs, they found that people who used these drugs were more likely to have developed dementia as those who didn’t use them. Moreover, dementia risk increased along with the cumulative dose. Taking an anticholinergic for the equivalent of three years or more was associated with a 54% higher dementia risk than taking the same dose for three months or less.

The ACT results add to mounting evidence that anticholinergics aren’t drugs to take long-term if you want to keep a clear head, and keep your head clear into old age. The body’s production of acetylcholine diminishes with age, so blocking its effects can deliver a double whammy to older people. It’s not surprising that problems with short-term memory, reasoning, and confusion lead the list of anticholinergic side effects, which also include drowsiness, dry mouth, urine retention, and constipation.

The University of Washington study is the first to include nonprescription drugs. It is also the first to eliminate the possibility that people were taking a tricyclic antidepressant to alleviate early symptoms of undiagnosed dementia; the risk associated with bladder medications was just as high.

“This study is another reminder to periodically evaluate all of the drugs you’re taking. Look at each one to determine if it’s really helping,” says Dr. Sarah Berry, a geriatrician and assistant professor of medicine at Harvard Medical School. “For instance, I’ve seen people who have been on anticholinergic medications for bladder control for years and they are completely incontinent. These drugs obviously aren’t helping.”

Many drugs have a stronger effect on older people than younger people. With age, the kidneys and liver clear drugs more slowly, so drug levels in the blood remain higher for a longer time. People also gain fat and lose muscle mass with age, both of which change the way that drugs are distributed to and broken down in body tissues. In addition, older people tend to take more prescription and over-the-counter medications, each of which has the potential to suppress or enhance the effectiveness of the others.

[ashleyjohn]

Thanks for the info Alice. This is really informative.

[alice]

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