Anticholinergic medications block the neurotransmitter acetylcholine in the nervous system. Acetylcholine is a neurotransmitter, which means it is involved in the transmission of a signal through the nervous system. Anticholinergic drugs can block acetylcholine in three areas of our nervous system depending on the type of drug. Anticholinergic drugs are used to treat a variety of conditions including dizziness, drug induced movement disorders, gastrointestinal disorders, genitourinary disorders, insomnia, respiratory disorders, sinus bradycardia and anti-depressants. There are many people today taking these medications today which makes recent findings a bit disturbing. Several recent studies have been finding a link between anticholinergic drugs and dementia.
A paper published 2015 in the Journal of the American Medical Association followed 3,434 Americans 65+ with no dementia at the start of the study in 1994 through 2012. They examined medication use and symptoms of each person in the study. Over the follow-up period, 797 participants (23.2%) developed dementia, and 637 of these (79.9%) developed Alzheimer’s disease. Researchers reported that taking the minimum daily effective dose of one the anticholinergic agents every day for 3 years would put people in the highest risk category for dementia. Additionally they commented that you could also get into the highest category by taking this dose sporadically over a longer period, or by taking a higher dose for a shorter period. In their conclusion they noted; “Higher cumulative anticholinergic use is associated with an increased risk for dementia. Efforts to increase awareness among health care professionals and older adults about this potential medication-related risk are important to minimize anticholinergic use over time.” Lead researcher on the study was quoted as saying: “There is no data on how these drugs may affect younger people, but I personally will avoid taking anticholinergic agents.”
A paper published in June 2016 measured brain size by imaging the brain of 491 older adults as well as tested their memory skills. The older adults taking at least 1 anticholinergic drug scored worse on memory testing and had a decrease in brain volume compared to the older adults not taking any anticholinergic medications. The authors of this paper concluded: ” The use of anticholinergic medication was associated with increased brain atrophy and dysfunction and clinical decline. Thus, use of anticholinergic medication among older adults should likely be discouraged if alternative therapies are available.”
A paper published April 2018 in the British Medical Journal also found a strong connection between anticholinergic drugs and dementia. In this study the researches examined records of 100,856 patients, 14,453 who where diagnosed with dementia and 86,403 who did not have a diagnosis of dementia. The patients in this study were aged 65-99 years old. They examined if any of these patients where ever prescribed anticholinergic drugs 4 to 20 years prior to a diagnosis of dementia. Their analysis showed a “positive and significant” association between any anticholinergic and dementia. The researchers noted that antidepressants, urologic drugs, and antiparkinson medications were most strongly associated with the development of dementia. The associations persisted 15 to 20 years after exposure. They noted that gastrointestinal drugs were not distinctively linked to dementia. In their conclusion the authors called it a “robust association” between some classes of anticholinergic drugs and future dementia.
Most, if not all, of theses studies look at older people, 65+, but I think the quote from the lead researcher from the 2015 study is very telling. She was planning to avoid taking any of these class of drugs for concern about their risk for developing dementia in the future. Follow this link to a list of anticholinergic drugs you or someone you know might be currently taking. When considering what you should or should not be taking evaluating your risk for dementia should be part of the equation if your doctor has prescribed an anticholinergic drug. If you are concerned about taking that medication discuss that concern with your doctor. Perhaps look up alternatives to the medication. Consider the idea that regular chiropractic care may help in the condition your doctor wants to treat with an anticholinergic drug. We cannot guarantee we can help but we have helped people with some of the conditions these drugs are supposed to treat.