Two recent reports in Science Daily suggest that some of the medicatios commonly prescribed for the elderly may, in fact, be contributing to their cognitive decline.

A study published in Journal of the American Geriatrics Society in 2008 examined the effects of exposure to anticholinergic medications, a type of drug used to treat a variety of disorders that include respiratory and gastrointestinal problems, on over 500 relatively healthy men aged 65 years or older with high blood pressure.
Some of these drugs also have properties that affect neurotransmitters in the brain that are important to overall brain function.

The researchers examined the total effects of all medications taken by the patients, both prescription and over-the-counter, that were believed to affect the function of a particular neurotransmitter, acetylcholine.
The findings show that chronic use of medications with anticholinergic properties may have detrimental effects on memory and the ability to perform daily living tasks, such as shopping and managing finances. Participants showed deficits in both memory and daily function when they took these medications over the course of a year. The degree of memory difficulty and impairment in daily living tasks also increased proportionally to the total amount of drug exposure, based on a rating scale the authors developed to assess anticholinergicity of the drugs.

Click here for the full report.

A clinical review now avaiable on linein the Journal of Clinical Interventions in Aging suggests that the amount of cognitive impairment caused by the drugs in older adults is not well recognised.

The reviewers conducted a systematic evidence-based analysis of 27 peer reviewed studies of the relationship of anticholinergic effect and brain function as well as investigating anecdotal information. They found a strong link between anticholinergic effect and cognitive impairment in older adults.

One of the goals of their work is to encourage the Food and Drug Administration to expand its safety evaluation process from looking only at the heart, kidney and liver effects of these drugs to include effects of a drug on the brain.

Many medications used for several common disease states have anticholinergic effects that are often unrecognised by prescribers. Indeed, 50% of the older adult population is estiamted to use a medication with some degree of anticholinergic effect each day so it is importatn for older adults and their physicians should have conversations about the benefits and harms of these drugs in relation to brain health.

Click here for the full report.

Click here for more articles on mental health in the elderly.

First Publishe in 2009

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