The American Geriatrics Society strongly recommends avoiding the use of anticholinergic medications in older adults, because seniors may be more likely to experience unwanted side effects than younger people. Anticholinergic drugs include:
\n\u2022 antidepressants (such as paroxetine-Paxil)
\n\u2022 anti-Parkinson\u2019s drugs
\n\u2022 anti-psychotic drugs (such as clozapine)
\n\u2022 urinary bladder relaxers (such as Enablex)
\n\u2022 some anti-nausea drugs (scopolamine), anti-asthma drugs (ipratropium), muscle relaxants (tizanidine), antihistamines (diphenhydramine-Benadryl), and anti-seizure drugs.<\/p>\n
One out of every three drugs prescribed for men and women over 65 are anticholinergic drugs, which are associated with increased risk for dementia (Zdr Varst<\/em>, Jun 2018;57(3):140\u2013147). A review of 21 studies involving 645,865 patients found that you are at a 46 percent increased risk for dementia if you take anticholinergic drugs for three months or more, and the longer you take these drugs the greater the risk (Neurourol Urodyn<\/em>, Oct 23, 2020). Taking these drugs for mental problems increases risk even more.<\/p>\n Not all anticholinergic drugs are associated with increased dementia risk, but the ones that affect primarily the brain are of greatest concern. High risk for dementia occurred when anticholinergic drugs were used to treat depression or Parkinson’s disease (JAMA Internal Medicine<\/em>, 2015;175(3):401-407). These studies were only on prescription anticholinergic drugs; they did not include over-the-counter drugs such as sleeping pills or antihistamines.<\/p>\n How Do Anticholinergic Drugs Function?<\/strong> Acetylcholine helps to send messages along parasympathetic nerves that control smooth muscles in the gastrointestinal tract, urinary tract, lungs, muscles, heart and other parts of the body (BMJ<\/em>, April 25, 2018;361:k1315). Anticholinergic drugs are often used to treat: Early Signs of Loss of Mental Function<\/strong>
\nAnticholinergics block a chemical called acetylcholine that is strongly related to your ability to pay attention, learn, remember and control muscle functions. People with Alzheimer’s dementia suffer from low levels of acetylcholine. Parkinson\u2019s disease is characterized by low levels of its opposing neurotransmitter, dopamine, that blocks the action of acetylcholine and overstimulates muscles to cause rigid muscles, jerking and shaking. Parkinson\u2019s disease is often treated with anticholinergic medications to block the action of acetylcholine. These anticholinergic medications can cause confusion, memory loss, hallucinations, and blurry vision. Most treatments for dementia increase acetylcholine levels in your body.<\/p>\n
\n\u2022 dizziness (vertigo or motion sickness)
\n\u2022 gastrointestinal disorders (ulcers, diarrhea, diverticulitis, ulcerative colitis, nausea, vomiting)
\n\u2022 genitourinary disorders (over-active bladder, incontinence, cystitis, urethritis, prostatitis)
\n\u2022 insomnia
\n\u2022 respiratory disorders (asthma, chronic bronchitis, chronic obstructive pulmonary disease)
\n\u2022 irregular heartbeats
\n\u2022 excessive salivation
\n\u2022 involuntary and excessive muscle movement (Parkinson\u2019s disease, tremors)
\n\u2022 side effects of some anti-psychotic medications
\n\u2022 some poisonings such as insecticides or poisonous mushrooms
\n\u2022 anxiety<\/p>\n
\nSymptoms of possible onset of dementia include:
\n\u2022 confusion
\n\u2022 short-term memory loss
\n\u2022 irrational thinking or behavior
\n\u2022 frequent arguing or uncontrolled anger
\n\u2022 making bad buying decisions or susceptibility to scams
\n\u2022 dropping out of a conversation
\n\u2022 unwarranted suspicion
\n\u2022 depression
\n\u2022 unexplained fear
\n\u2022 being easily upset
\n\u2022 forgetting names or appointments
\n\u2022 forgetting to pay bills
\n\u2022 difficulty completing tasks
\n\u2022 reduced ability to work with numbers
\n\u2022 difficulty concentrating on games, movies or television programs
\n\u2022 difficulty reading
\n\u2022 inability to carry on a logical conversation
\n\u2022 repeatedly losing or misplacing things
\n\u2022 failure to take care of usual grooming habits
\n\u2022 withdrawal from usual activities<\/p>\n