Are certain anticholinergic meds linked to dementia risk?

The validity of a new large study linking anticholinergic drugs to the risk of dementia has stirred up controversy.

The observational study, published in the June 24 JAMA Internal Medicine, found that people who take certain anticholinergic antidepressants, antiparkinson drugs, antipsychotic drugs, bladder antimuscarinics, and antiepileptic drugs over a long period of time had an increased risk of developing dementia as they age.

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“Exposure to several types of strong anticholinergic drugs is associated with an increased risk of dementia. These findings highlight the importance of reducing exposure to anticholinergic drugs in middle-aged and older people,” the authors wrote.

However, Robert Goldberg, co-founder and vice president of the Center for Medicine in the Public Interest, questioned the validity of the study.

“The study did not control for diagnosis of depression, schizophrenia, and epilepsy as the causal factor, even though lots of other research shows this might be the case. And we don't know if the dementia risk is higher in people that go untreated for such conditions,” Goldberg told FormularyWatch.

The researchers evaluated the total standardized daily doses (TSDDs) of anticholinergic drugs prescribed in the 1 to 11 years prior to the date of diagnosis of dementia or equivalent date in matched controls.

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While anticholinergic drugs have been linked to dementia in past studies, the new study is large and it analyzed the use of the medications in more detail and over a longer period of time than many previous studies, The New York Times reported.

The nested case-control study, which took place in general practices in England that contributed to the QResearch primary care database, evaluated dementia risk in 58, 769 patients with a diagnosis of dementia and 225,574 controls who were aged 55 years or older.

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