Common drugs that increase the risk of Alzheimer's disease

A new study suggests that anticholinergic drugs may increase the risk of accelerated cognitive decline. Particularly in the elderly who are at high risk of developing Alzheimer’s disease.

Depression, urinary incontinence, seasonal allergies: the most prescribed drugs are the most at risk

Anticholinergic drugs block the action of acetylcholine, a chemical messenger that controls a variety of automatic bodily functions and plays an essential role in memory and attention. Doctors prescribe these drugs for a variety of conditions. These include urinary incontinence, overactive bladder, chronic obstructive pulmonary disease (COPD), seasonal allergies and depression.

However, over the past decade, there has been growing evidence many indicate that anticholinergics may increase the risk of dementia in older people. Researchers at the University of California, San Diego, have now linked anticholinergics to mild cognitive impairment, which can lead to dementia, including Alzheimer’s disease.

The increased risk was especially pronounced in people who had biomarkers of Alzheimer’s disease in their cerebrospinal fluid and in those who had an increased genetic risk of developing the disease. This interaction between anticholinergic drugs and Alzheimer’s risk biomarkers works doubly effectively. In the first case, biomarkers for Alzheimer’s disease indicate that degeneration begins in a small region of the brain called the basal forebrain, which produces acetylcholine. Then, in the second case, anticholinergic drugs further deplete acetylcholine stores in the brain. This combined effect has a very large impact on a person’s thinking and memory.

An increase in 47% risk of cognitive impairment

The study focused on 93 people who participated in the Alzheimer’s disease neuroimaging initiative. The participants had an average age of 50 years, and none showed signs of cognitive or memory problems at the start of the study. A third of them were taking at least one type of medication, with an average of 4.7 anticholinergic drugs per person. There were no differences in genetic risk factors between people taking anticholinergics and those not taking anticholinergics.

However, depressive symptoms, total number of drugs and heart problems were more severe in people taking anticholinergics. So these variables were taken into account in all subsequent analyzes. From the start of the study, participants took annual cognitive tests for a period of up to 09 years.

Among those taking at least one anticholinergic, there was an overall increase in 29% risk of mild cognitive impairment compared to those who did not take any. Those who took these drugs and were genetically at risk for developing Alzheimer’s disease were more than 2.5 times more likely to develop mild cognitive impairment than those who did not take the drugs and were not genetically at risk. . Participants who had Alzheimer’s biomarkers in their cerebrospinal fluid at the start of the study and who were taking anticholinergics were almost 5 times more likely to show signs of mild cognitive impairment.


The results of the study are published in the journal Neurology. 2020 / 09 / 02 / WNL. 0000000000010643

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