Many people are unaware that dozens of painkillers, antihistamines and psychiatric medications from drugstore staples to popular antidepressants can adversely affect brain function, mostly in the elderly. Regular use of multiple medications that have this effect has been linked to cognitive impairment and memory loss.
Called anticholinergics, the drugs block the action of the neurotransmitter acetylcholine, sometimes as a direct action, but often as a side effect.
Acetylcholine is a chemical messenger with a range of functions in the body, memory production and cognitive function among them.
The difficulty for patients is that the effect of anticholinergic drugs is cumulative. Doctors are not always aware of all of the medications their patients take, and they do not always think to review the anticholinergic properties of the ones they prescribe.
It’s a particular problem for older patients, who are more vulnerable to the effects of these drugs and who tend to take more medicines overall.
After following more than 13,000 British men and women or older for two years, researchers found that those taking more than one anticholinergic drug scored lower on tests of cognitive function than those who were not using any such drugs, and that the death rate for the heavy users during the course of the study was 68 per cent higher.
That finding, reported last July in The Journal of the American Geriatrics Society, stunned the investigators.
“So far we can’t tell why they are dying, but it wasn’t because they were sicker or older,” said Dr Malaz A Boustani, director of the Wishard Healthy Aging Brain Center and a scientist at the Regenstrief Institute, both in Indianapolis, who was one of the paper’s authors. “We adjusted for age, gender, race, other medications they were taking, other diseases and social status. We adjusted for everything we could, and that signal did not go away.”
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