Anticholinergics (Such as Detrol®) and Cognitive Decline

Sometimes possible side-effects of drugs only emerge after a long period of general use. The latest example is the regular taking of anti-cholinergics. According to a report given at the American Academy of Neurology meeting, anticholinergic drug use had detrimental effects on mental abilities in older patients.

The study in question was done in 870 Catholic nuns and clergy members who were 75 or older. They were free of dementia at baseline. During the next 7.8 years the participants were studied using a 21-item neuropsychological test battery. Medication use was recorded.

Two-thirds of the participants had taken an anticholinergic drug at least once during the follow-up period. These drugs included agents for an overactive bladder, Parkinson’s disease, fluid retention, and other disorders. The level of cognitive decline was about 1.5 times faster in those who had taken an anticholinergic drug than in those who hadn’t. This was a statistically significant difference – i.e. it would not have occurred by chance alone.

The chief investigator stated that “although their rate of [cognitive] decline was greater, there was no difference in the rate of being diagnosed with Alzheimer’s disease”. He is now examining the anticholinergic drugs used to see which, if any, were more likely to accelerate cognitive decline. The list is likely to be long – some antidepressants, some asthma medications, some antihistamines, some gastro-intestinal antispasmodics, as well as the types mentioned above. If you are worried or in doubt, read the package insert and look for the classification, drug category, or mechanism of action paragraphs.