THURSDAY, April 17 (HealthDay News) -- Common medications known
as anticholinergic drugs -- used to treat ulcers, stomach cramps,
motion sickness, Parkinson's disease and urinary incontinence --
may cause older people to lose their thinking skills more quickly
than seniors who don't take the medicines, new research
suggests.
"What we found is being on these drugs does worsen your
cognitive performance," said Dr. Jack Tsao, an associate professor
of neurology at Uniformed Services University in Bethesda, Md., who
led the study of the effect of the medications on older adults who
were, on average, 75. "In the course of a few years, there is a
small slippage. It's a minor effect."
Medications for bladder problems and Parkinson's appear to have
the worst effect on memory, he said.
Anticholinergic drugs are a class of medicines that work by
blocking the binding of a brain chemical called acetylcholine to
its receptor in nerve cells.
"You need acetylcholine for [good] memory," Tsao explained.
Drugs used to treat Alzheimer's inhibit the enzyme which breaks
down acetylcholine, he said, allowing more of it to be used by the
brain.
Tsao was expected to present his research Thursday at the
American Academy of Neurology annual meeting, in Chicago.
Tsao's study adds to the body of evidence on the effect of these
drugs on memory. "We've known for a long time that in people with
Alzheimer's disease, if you put them on drugs with anticholinergic
activity, it clearly worsens their memory, without a doubt."
In the new study, he said, they looked at people who had normal
cognitive function.
"Taking the drugs doesn't increase your risk of getting
Alzheimer's. There was no change in the progression overall to the
diagnosis of Alzheimer's," Tsao stressed. However, there was a
decline in cognitive abilities.
Tsao's group evaluated the annual changes in thinking ability of
870 Catholic nuns and clergy members who are part of an ongoing
study of older people called the Rush Religious Orders Study.
During the eight-year follow-up, 679 participants took at least
one medicine that was an anticholinergic. Those who took the drugs
had a rate of cognitive function decline that was 1.5 times faster
than those not on the drugs.
Overall, those not on the drugs had a decline in cognitive
performance of about 0.5 on the scale used, Tsao said. Those on the
medicines showed a decline of 1.5.
When they looked more closely at individual drugs, they found
those used for bladder problems and Parkinson's disease impaired
memory about three times as much as those not taking
anticholinergic drugs.
Another study, published in 2006 in the
British Medical Journal, found that elderly people taking
anticholinergics had poorer performance on memory and other tests
than those who didn't take the drugs.
Another expert, Dr. Niall Galloway, a urologist and director of
the Emory University Continence Center in Atlanta, said one
strength of the study is that it includes relatively large numbers.
Overall, however, he said, "this is not a strong study."
One major problem, he said is that the volunteers are "lumped
together," regardless of what the indication is for taking an
anticholinergic. It would be helpful to know more specific
information, such as how many anticholinergics each patient was
taking and how those taking one compared to those taking more than
one.
Tsao agreed that more specific information would be better.
Meanwhile, he said, "my recommendation is, if someone is having
what they feel is a noticeable problem with their ability to
remember things, they need to go see their doctor. And they need to
mention if they are on one of these drugs."
Galloway agreed, saying that many patients may stay on
medications longer than they need to, either because they forget to
ask the doctor about it or the doctor doesn't re-evaluate. It's a
fair question, he said, to ask your doctor if you need to continue
a medication.
More information
To learn more about older adults and medications, visit the
U.S. National Institute on Aging.