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Title: Use of Anticholinergic Drugs Hastens Decline in Cognitive Function Among Older Individuals: Presented at AAN
URL: http://www.pslgroup.com/dg/21FE32.htm
Doctor's Guide
April 21, 2008

By Ed Susman

CHICAGO -- April 21, 2008 -- Older individuals who take anticholinergic drugs for treatment of such conditions as overactive bladder appear to have a 1.5-times greater decline in cognitive functioning, according to data presented here at the American Academy of Neurology (AAN) 60th Annual Meeting.

Researchers evaluated the relationship between the use of anticholinergic agents and the annual change in cognitive ability by evaluating data culled from Chicago's Rush University Religious Orders Study.

"Our findings point to anticholinergic drugs having an adverse impact on cognitive performance in otherwise normal, healthy older people," said Commander Jack Tsao, MD, DPhil, Associate Professor of Neurology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, and a neurologist with the US Navy.

In his oral presentation on April 17, Dr. Tsao presented the findings from studies of 870 Catholic nuns and clergy members who took part in the study and were aged more than 75 years. During the 7.8 years of follow-up, 679 participants in the study had taken an anticholinergic dose at least once and there were 191 patients who had not taken anticholinergic medicines. Those drugs include bladder agents, Parkinson's disease drugs, diuretics, and other agents.

"Before the subjects began taking these medications their rate of cognitive decline was similar to that of individuals not taking the medications," Dr. Tsao said. "After they began taking drugs with anticholinergic properties it turned out that the decline over time in their cognitive performance was about 1.5 times greater than in those who were not taking the drugs."

He said the difference in the rate of decline reached statistical significance at the P = .004 level.

"Even though their rate of decline was greater, there was no difference in the risk of being diagnosed with Alzheimer's disease," he said. He explained that the rate of decline, while significant, did not reach an extent that it led to a definition of dementia.

"We are now evaluating the list of drugs to determine if we can find which are most likely to contribute to decline in cognitive functioning," said Dr. Tsao.


[Presentation title: Impaired Cognition in Normal Individuals Using Medications With Anticholinergic Activity Occurs Following Several Years. Abstract S51.001]

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