The University of East Anglia’s Medical Research Council’s Cognitive Function and Ageing Studies (CFAS) have released the results of the first systematic study of the effect of some common medications used to treat a variety of conditions, but which all share an anti-cholinergic effect and are often taken by elderly people:
The groups with the greatest impact include: anti-depressants such as Amitriptyline, Imipramine and Clomipramine; tranquilisers such as Chlorpromazine and Trifluoperazine; bladder medication such as Oxybutynin; and antihistamines such as Chlorphenamine. Other drugs with an anticholinergic effect include: Atenolol, Furosemide and Nifedipine for heart problems; painkillers such as Codeine and Dextropropoxyphene; the asthma treatment Beclometasone; the epilepsy treatment Carbamazepine; and Timolol eyedrops which are used for glaucoma.
The study produced a number of interesting key findings:
- Twenty per cent of participants taking drugs with a total ACB of four or more had died by the end of the two-year study, compared with only seven per cent of those taking no anticholinergic drugs – the first time a link between anticholinergics and mortality has been shown.
- For every additional ACB point scored, the odds of dying increased by 26 per cent.
- Participants taking drugs with a combined ACB of five or more scored more than four per cent lower in a cognitive function test than those taking no anticholinergic medications – confirming evidence from previous smaller studies of a link between anticholinergics and cognitive impairment.
- The increased risks from anticholinergic drugs were shown to be cumulative, based on the number of anticholinergic drugs taken and the strength of each drug’s anticholinergic effect.
- Those who were older, of lower social class, and with a greater number of health conditions tended to take the most anticholinergic drugs.
For more information on this study, visit the University of East Anglia’s site.