Common Medication Associated With Cognitive Decline in Elderly

The *Journal of the American Geriatrics Society* issued the followingnews release about a study ("Cumulative Anticholinergic Exposure IsAssociated with Poor Memory and Executive Function in Older Men")

A study published in Journal of the American Geriatrics Societysuggested that the use of certain medications in elderly populations maybe associated with cognitive decline. The study examined the effects ofexposure to anticholinergic medications, a type of drug used to treat avariety of disorders that include respiratory and gastrointestinalproblems, on over 500 relatively healthy men aged 65 years or older withhigh blood pressure.

Older people often take several drugs to treat multiple healthconditions. As some of these drugs also have properties that affectneurotransmitters in the brain that are important to overall brainfunction, the researchers examined the total effects of all medicationstaken by the patients, both prescription and over-the-counter, that werebelieved to affect the function of a particular neurotransmitter,acetylcholine.The findings show that chronic use of medications with anticholinergicproperties may have detrimental effects on memory and the ability toperform daily living tasks, such as shopping and managing finances.Participants showed deficits in both memory and daily function when theytook these medications over the course of a year. The degree of memorydifficulty and impairment in daily living tasks also increasedproportionally to the total amount of drug exposure, based on a ratingscale the authors developed to assess anticholinergicity of the drugs.According to study co-author Dr. Ling Han of the Yale UniversityDepartment of Internal Medicine, elderly patients may be more vulnerableto these types of medications due to neurological and pharmacokineticalchanges related to aging."This study extends our previous findings on acute cognitive impairmentfollowing recent anticholinergic exposure in older medical inpatients,"says Han. "Prescribing for older adults who take multiple prescriptionand over-the-counter medications requires careful attention to minimizethe risk of potential harms of the drugs while maximizing their healthbenefits."