Common drugs hasten decline in elderly

Courtesy of Reuters

Elderly people who took commonly prescribed drugs for incontinence, allergy or high blood pressure walked more slowly and were less able to take care of themselves than others not taking the drugs. U.S. researchers said people who took drugs that block acetylcholine -- a chemical messenger in the nervous system critical for memory -- functioned less well than their peers. "These results were true even in older adults who have normal memory and thinking abilities," said Dr. Kaycee Sink of Wake Forest University School of Medicine in North Carolina, who led the study of 3,000 people of whom 40 percent were taking more than one anticholinergic drug. "The effect is essentially that of a three- to four-year increase in age. So someone who is 75 in our study and taking at least one moderately anticholinergic medication is at a similar functional level to a 78 to 79-year-old," Sink said in an e-mail.

Sink's findings, presented at American Geriatrics Society Meeting in Washington, add to a growing body of research that suggests these so-called anticholinergic medications can hasten functional and cognitive declines in elderly people. Some of the most common such drugs in the study included the blood pressure drug nifedipine (sold as Adalat or Procardia), the stomach antacid ranitidine or Zantac, both with mild or moderate anticholinergic properties, and Pfizer Inc's incontinence drug tolterodine or Detrol, which is highly anticholinergic. "The tricky part ... is that many useful drugs from many different classes of medications have anticholinergic properties," Sink said.

Dr. Jack Tsao, a neurologist with the U.S. Navy, reported last month at a American Academy of Neurology meeting that elderly people who took anticholinergic drugs had a 50 percent greater rate of memory decline than people in a long-term study who did not take the drugs.

In a separate study this month in the Journal of the American Geriatrics Society, Sink found that older nursing home residents who took drugs for dementia and incontinence at the same time had a 50 percent faster decline in function than those treated only for dementia. "I would encourage patients to bring in a list of everything they take (even over-the-counter medications) to their doctor and have them review it at least yearly," Sink said. "Physicians should try to decrease anticholinergic burden whenever possible."

Bonnie - finally, we are beginning to see some research on this issue. The elderly are usually on more medications than any other part of the population. In many cases, it becomes a vicious circle where one medication is prescribed to counter the side effects from another medication. As I always say, it does not matter what age you are, discuss with your physician how to take the minimum number of meds (if any at all) that are medically necessary.