These drugs, called anticholinergics, block acetylcholine, a nervous system neurotransmitter, and are widely-used medical therapies. They are sold over the counter under various brand names such as Benadryl®, Dramamine®, Excedrin PM®, Nytol®, Sominex®, Tylenol PM®, and Unisom®. Other anticholinergic drugs, such as Paxil®, Detrol®, Demerol® and Elavil® are available only by prescription. Older adults most commonly use drugs with anticholinergic effects as sleep aids and to relieve bladder leakage problems.
Taking one anticholinergic significantly increased an individual’s risk of developing mild cognitive impairment and taking two of these drugs doubled this risk.
Researchers from Indiana University School of Medicine, the Regenstrief Institute and Wishard Health Services conducted a six-year observational study, evaluating 1,652 Indianapolis area African-Americans over the age of 70 who had normal cognitive function when the study began. In addition to monitoring cognition, the investigators tracked all over-the-counter and prescription medications taken by study participants.
It is confirmed that anticholinergics, something as seemingly benign as a medication for inability to get a good night’s sleep or for motion sickness, can cause or worsen cognitive impairment, specifically long-term mild cognitive impairment which involves gradual memory loss. Patients were advised not to take these drugs and all older adults need to talk to their physicians about each and every one of the medications they take.
Although this study, which was funded by the National Institute on Aging, looked at only African-Americans, both Dr. Campbell and Dr. Boustani believe future studies will find that the results are generalizable to other races.
A downloadable list of medications with anticholinergic effects can be found on the website of the Indianapolis Discovery Network for Dementia, of which Dr. Boustani is the founder and scientific director.