Anticholinergic drugs linked with greater cognitive risk

In the journals

Many commonly used drugs have anticholinergic effects, meaning the drugs block the action of acetylcholine. Nerve cells release acetylcholine to transmit impulses to other nerves in the brain and throughout the body. Previous research has shown a link between these drugs and dementia. Now a study has found a similar link with mild cognitive impairment (MCI), especially if you take larger doses. The findings were published online Sept. 2, 2020, by Neurology.

Some medications are designed purposefully to block acetylcholine, such as those used for urinary incontinence. But more often the anticholinergic action is a side effect of drugs taken to treat conditions like allergies, colds, and depression.

Researchers recruited 688 adults, average age 74, who had no cognitive problems. Everyone received annual cognitive tests for up to 10 years. Those who regularly took at least one anticholinergic drug were 47% more likely to get MCI — often a precursor to dementia like Alzheimer's disease — compared with those who did not take the drugs. Higher doses also appear to be associated with a greater risk of developing MCI. About 75% of the group took two to four times more than the recommended minimum amount. The researchers stressed the importance for older adults to regularly review their medications with their doctors and be mindful about following proper dosages.

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