Older people risk memory loss from everyday drugs

Many older people who are are becoming forgetful or disorientated may find that their loss of mental function may be in fact due to taking their everyday medication.

According to a new large-scale study on African American older people aged over 70, certain drugs, which may carry some additional risk of memory loss, are those prescribed to treat older people for insomnia, allergies and bladder control and belong to a class of drug called anticholinergics.

Anticholinergics are drugs that block the activity of acetylcholine. This is a chemical messenger that carries messages between cells. The problem with anticholinergics is that they can cause short-term cognitive impairment, with symptoms of confusion, memory loss and temporary disorientation. Many common sleeping tablets, containing an anticholinergic called diphenhydramine are prescribed for older people. They include such tablets as Dreemon, Medinex, Nightcalm, and Nytol. Drugs used to treat bladder control include darifenacin (Emselex), flavoxate (Urispas), and oxybutynin (Cystrin, Ditropan). Other medical conditions treated by anticholinergics are epilepsy, nausea, stomach and bowel problems, depression and Parkinson's disease.

It was found that regular use of one anticholinergic drug increased the incidence of decline of mental function after six years, compared with those who took none. The risk was doubled if the two anticholinergics were taken on such a regular basis. There are fears that such drugs could lead to dementia or Alzheimer's if taken long term. However, this study found no such link and also concluded that the other problems were quite mild.

At the commencement of the study, the researchers kept records of all the medications that the respondents were taking and they tested their cognitive abilities to ensure they had no problems with memory, language and attention. The researchers took detailed records in the participants' homes of all the medications they were taking, whether prescription or non prescription, so the study was very thorough. They also conducted reliable tests of the participants' mental function. Follow-ups were made three and six years later to test for possible loss of mental function.

It was found overall that people taking anticholinergics had a 46 per cent increased chance of losing some cognitive function, but the effect was mild and did not include Alzheimer's or other kinds of dementia.

The next study undertaken will determine if any such mental decline caused by taking anticholinergics is reversible. Another aspect which needs to be looked into is whether in fact those taking anticholinergics were at risk of mental decline for other reasons such as sleep problems.

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