Anticholinergic drugs block a common neurotransmitter named acetylcholine, in both the central and peripheral nervous system. It is used for a variety of conditions like chronic migraine, Irritable Bowel Syndrome, and Neurogenic cough. Examples of these medicines include antihistamines, antidepressants, and gastrointestinal and bladder agents.

This study highlights the potential danger of using long-term anticholinergics that can affect the brain in patients older than 55 years old. It demonstrated a statistically significant association between dementia and cumulative use of anticholinergics. The sample size of this study was rather large and impressive. However, the retrospective study design (as opposed to a randomized prospective design) is a major limitation. Also, the magnitude of the risk was not very high in my opinion, although it was statistically higher than the risk in the control group.

For patients who take a lot of Benadryl or higher dosage anticholinergics or certain bladder medications, they may already be at a higher risk of dementia. Such association suggest that doctors should be more cautious when prescribing anticholinergics. We should investigate other options for treatment, particularly in elderly folks.

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Author Rebekah Kim Surgery and Special Projects Coordinator