Common Drugs Tied to Increased Risk of Cognitive Decline, Fi
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A class of drugs used for many conditions, including allergies, colds, high blood pressure and depression, may be associated with an increased risk of developing mild thinking and memory problems, particularly in people who have genetic risk factors for Alzheimer’s disease or markers of this condition, according to a study published online today in journal Neurology.

These types of drugs, called anticholinergic drugs, are used for motion sickness, urinary incontinence, overactive bladder, Parkinson’s disease and high blood pressure. There are approximately 100 such drugs in widespread use, with some requiring a prescription and many others that may be purchased over the counter.

The study involved 688 people with an average age of 74 who had no problems with thinking and memory skills at the start of the study. The participants reported if they were taking any anticholinergic drugs within three months of the start of the study at least once a week for more than six months. They took cognitive tests once a year for up to 10 years.

One-third of the participants were taking anticholinergic drugs, with an average of 4.7 anticholinergic drugs taken per person. Metoprolol, atenolol, loratadine and bupropion were the most common.

Of the 230 people who were taking anticholinergic drugs, 117 people, or 51%, later developed mild cognitive impairment, compared to 192 people, or 42%, of the 458 people who were not taking the drugs. After adjusting for depression, number of medications being taken, and history of cardiac problems, individuals taking at least one anticholinergic drug had a 47% increased risk for developing mild cognitive impairment. Furthermore, those with higher overall exposure to anticholinergic drugs had additional increased risk.

The study found that people with biomarkers for Alzheimer's disease in their cerebrospinal fluid who were taking anticholinergic drugs were four times more likely to later develop mild cognitive impairment than people who were not taking the drugs and did not have the biomarkers.

Similarly, people who had genetic risk factors for Alzheimer's disease and took anticholinergic drugs were about 2.5 times as likely to later develop mild cognitive impairment than people without the genetic risk factors and who were not taking the drugs.

Source: https://n.neurology.org/content/early/2020/09/02/WNL.0000000000010643
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