Increasing the Chance of Dementia through Specific Medications?
Chat with a Pharmacist: Anticholinergics and Dementia - Uncovering the Connection
Ever wondered if your meds could be increasing your dementia risk? Let's take a deep dive into anticholinergics, their link with dementia, and what you can do about it. Here to guide us is Gina Ayers, a seasoned geriatric pharmacist.
Q: Is there any evidence that anticholinergic drugs increase your risk for dementia?
A: Yes, there are studies, such as the one in the June 2019 Journal of the American Medical Association (JAMA), confirming a link between anticholinergics and dementia, although it didn't prove a direct cause. We try to help patients minimize usage of these medications whenever possible due to the known increased dementia risk. Many of our patients have reported improved cognition when free from these medications.
Q: Which medications are associated with dementia risk?
A: The American Geriatric Society's 2019 updated Beers Criteria advises avoiding certain medications in older adults, such as anticholinergics and hypnotics, due to their potential contribution to or worsening of dementia.
Anticholinergics are a broad class of drugs, found in treatments for conditions like urinary incontinence, depression, muscle spasms, and even allergies. They can also be found in over-the-counter medications for sleep or nighttime symptoms. Many over-the-counter sleep aids contain diphenhydramine, which can affect cognition. We advise being cautious when using such medications, particularly if you have cognitive concerns.
Hypnotics like benzodiazepines and medications like zolpidem (Ambien) are commonly prescribed for sleep or anxiety. If you have dementia, problems with memory, or cognitive concerns, it's best to seek alternatives with fewer cognitive effects.
Q: How do anticholinergics affect dementia risk?
A: Anticholinergics block acetylcholine, a chemical critical for nervous system functions. Over time, this can result in cognitive changes, with seniors becoming increasingly sensitive to these effects. While we don't yet have conclusive proof that they cause dementia, we often observe improved cognitive function when patients discontinue these medications.
Q: Who is most at risk for adverse effects from these medications?
A: As you age, you become more sensitive to the effects of these medications, and they may have cumulative effects if you take more than one or use them for extended periods.
Q: If you're someone taking these medications, what should you do?
A: If you have concerns, speak to your doctor or geriatric team before stopping these medications. Sudden discontinuation may result in worsening effects. Your provider can determine whether the medication should be tapered and recommend safer substitutions or non-medication treatment options. Be informed, ask questions, and speak with your provider about any over-the-counter medications you're using, as they can potentially cause adverse effects.
- The use of anticholinergic drugs, commonly found in treatments for conditions such as urinary incontinence, depression, allergies, and muscle spasms, has been linked to an increased risk of dementia.
- Mental health conditions, such as depression, and neurological disorders, like dementia, may be exacerbated by the use of hypnotics, a class of medications that includes benzodiazepines and zolpidem (Ambien).
- As people age, they become more sensitive to the effects of anticholinergic medications, and the risk of adverse effects may increase if these medications are taken for extended periods or in combination with others.
