In a case-control study in older adults, it was observed a robust association between exposure to different classes of anticholinergic drugs and future dementia incidence.
The researchers used a large UK primary care database, Clinical Practice Research Datalink, and matched 40,770 older adults with a diagnosis of dementia to 283,933 controls without dementia. Until dementia diagnosis (4 to 20 years), an anticholinergic drug with a high anticholinergic burden (e.g., amitriptyline, paroxetine) were prescribed in 36% of cases and 30% of controls. It was found that increasing exposure to highly anticholinergic drugs was associated with increased dementia risk. The risk was highest with antidepressants, anti-Parkinson drugs, and urologic drugs.
The researchers concluded that "Clinicians should continue to be vigilant with respect to the use of anticholinergic drugs, and should consider the risk of long term cognitive effects, as well as short term effects, associated with specific drug classes when performing their risk-benefit analysis."
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