- May 9, 2018
- Posted by: PharmaScroll
- Category:
A recent study, published in BMJ, found a robust association between some classes of anticholinergic drugs and future dementia incidence. The study was conducted with an aim to estimate the association between the duration and level of exposure to different classes of anticholinergic drugs and subsequent incident dementia.
The study was a case-control study and was conducted in General practice setting in the UK contributing to the Clinical Practice Research Datalink. Study participants included 40,770 patients aged 65-99 with a diagnosis of dementia between April 2006 and July 2015, and 283,933 controls without dementia.
As a part of the study, Daily defined doses of anticholinergic drugs were coded using the Anticholinergic Cognitive Burden (ACB) scale, in total and grouped by subclass, prescribed 4-20 years before a diagnosis of dementia. The major outcome measure in the study was the odds ratios for incident dementia, adjusted for a range of demographic and health related covariates.
Results of the study:
The results of the study highlighted that 14,453 (35%) cases and 86,403 (30%) controls were prescribed at least one anticholinergic drug with an ACB score of 3 (definite anticholinergic activity) during the exposure period. The adjusted odds ratio for any anticholinergic drug with an ACB score of 3 was 1.11 (95% confidence interval 1.08 to 1.14). Dementia was associated with an increasing average ACB score. When considered by drug class, gastrointestinal drugs with an ACB score of 3 were not distinctively linked to dementia. The risk of dementia increased with greater exposure for antidepressant, urological, and antiparkinson drugs with an ACB score of 3. This result was also observed for exposure 15-20 years before a diagnosis.
The study concluded that a robust association between some classes of anticholinergic drugs and future dementia incidence was observed. This could be caused by a class specific effect, or by drugs being used for very early symptoms of dementia. The study further underlined the need for future research to examine anticholinergic drug classes as opposed to anticholinergic effects intrinsically or summing scales for anticholinergic exposure.
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News Source: https://www.bmj.com/content/361/bmj.k1315
Image Source: https://www.brightfocus.org/alzheimers/article/what-causes-dementia