Medicalresearch.com Interview with:
Professor Phyo Kyaw Myint
Chair in Old Age Medicine
University of Aberdeen
Medicalresearch.com: What is the background for this study?
Response: We have previously studied the potential harmful effects of a group of medications called anticholinergics. They can have side effects on central as well peripheral systems. The link between use of these drugs and dementia is less well understood due to limitations of previous studies.
We used large GP practices data from the UK with long term follow up and examined this association using robust statistical methods.
Medicalresearch.com: What are the main findings?
Response: Key findings are:
- Drugs with anticholinergic properties which are used to treat depression, urological conditions (e.g. for overactive bladder) and Parkinsonism are linked to development of dementia.
- Drugs with similar properties which are used to treat gut disorders and heart conditions are not found to be linked to dementia
- Drugs with low level of anticholinergic effect are not linked to dementia
Medicalresearch.com: What should readers take away from your report?
Response: Clinicians should use the drugs with high level of anticholinergic burden cautiously. Also attempts should be made whenever appropriate to reduce or replace with similar drugs but without such properties.
Medicalresearch.com: What recommendations do you have for future research as a result of this study?
Response: We need to ensure confounding effects are minimised by conducting carefully designed prospective studies. Further clinical trial evidence of benefit of deprescribing of these medications (when possible) in at risk populations is also urgently warranted.
Medicalresearch.com: Is there anything else you would like to add? Any disclosures?
Response: In the absence of trial evidence, this study provides best available evidence using robust statistical methods in the largest study of its kind and will help clinicians in making treatment choices for the benefit of the patients.
Anticholinergic drugs and risk of dementia: case-control study
BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k1315 (Published 25 April 2018)Cite this as: BMJ 2018;361:k1315
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