27 June 2011

Large number of common drugs linked to brain impairment

by Kate Melville

A large, long-term study just published in the Journal of the American Geriatrics Society has found that medications that exhibit anticholinergic activity - typically over-the-counter and prescription drugs taken by older adults - cause cognitive impairment. The two-year study of the impact of these medications on 13,000 men and women aged 65 and older is part of a large longitudinal multi-center study initiative looking at health and cognitive function in older adults.

Medications with anticholinergic effects are used for many diseases including hypertension and congestive heart failure. Anticholinergics affect the brain by blocking acetylcholine, a nervous system neurotransmitter. Over-the-counter products that work in this way include: Benadryl�, Dramamine�, Excedrin PM�, Nytol�, Sominex�, Tylenol PM� and Unisom�. Prescription drugs include: Paxil�, Detrol�, Demerol� and Elavil�.

The study looked at those drugs with either moderate or severe anticholinergic activity. "After adjusting for age, sex, baseline mental status, education, income level, number of non-anticholinergic medications and health conditions, we found that taking anticholinergic medications was linked to cognitive impairment and, for the first time, to death," said study co-author Dr. Chris Fox, from the University of East Anglia, UK. "We need follow-up to determine the degree to which anticholinergics are being prescribed for diseases with significant risk of death and the impact of that on our findings."

The researchers stress the need for doctors to review the cumulative anticholinergic burden in people presenting with cognitive impairment to determine if the drugs are causing their decline in mental status.

"Physicians should review with older patients all the over-the-counter and prescription drugs they are taking to determine exposure," concluded Dr. Malaz Boustani a geriatrician at the Indiana University School of Medicine.

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Source: Indiana University School of Medicine