Anticholinergics May be Associated With Increased Risk of Mild Cognitive Impairment

According to a study published in Neurology, an increase of risk developing mild cognitive impairment (MCI) may be associated with use of anticholinergic medications. The cognitive decline is shown in individuals with genetic conditions for Alzheimer disease (AD) or markers of this condition, 
 
The study found that people without cognitive impairments who took an anticholinergic medication were 47% more likely to develop MCI over the next decade. Of those who were taking anticholinergic drugs, 51% (117/230/688) developed MCI, compared with 42% (192/458) of the participants who were not taking anticholinergics. After adjusting for depression, number of medications being taken, and history of cardiac problems, individuals taking at least one anticholinergic drug had a 47% increased risk for developing MCI. Those with higher overall exposure to anticholinergics had additional increased risk. 

Individuals with biomarkers for AD who took anticholinergics were 4 times more likely to later develop MCI compared with participants without biomarkers who did not take anticholinergics. 
  
Participants' were mean age 74 with no cognitive impairments at the start of the study. The participants reported if they were taking any anticholinergic within 3 months of enrollment once a week for more than 6 months. They took cognitive tests once a year for up to 10 years. One-third of the participants were taking an average of 4.7 anticholinergic medications, most commonly medication used were metoprolol, atenolol, loratadine, and bupropion. 

“Our findings suggest that reducing the use of anticholinergic drugs before people develop any cognitive problems may be an important way to prevent the negative consequences of these drugs on thinking skills, especially for people who have an elevated risk of developing AD,” said study author Lisa Delano-Wood, PhD, of the University of California, San Diego. “Future studies are needed to see if indeed stopping the use of these drugs could lead to a reduction in mild cognitive impairment and AD down the road.”