Conclusions and Relevance Exposure to several types of strong anticholinergic drugs is associated with an increased risk of dementia. These findings highlight the importance of reducing exposure to anticholinergic drugs in middle-aged and older people.
Introduction
An estimated 47 million people worldwide were living with dementia in 2015,1 while in the United States around 5.7 million people have Alzheimer dementia.2 Modifiable risk factors, including hypertension, hearing loss, depression, diabetes, and smoking, account for around 35% of dementia cases.1 Anticholinergic drugs are another potentially modifiable risk factor. This broad group of drugs acts by blocking the neurotransmitter acetylcholine in the central and peripheral nervous system and includes some antihistamines, antidepressants, and medications for gastrointestinal and bladder disorders. These medicines can have short-term adverse effects, including confusion and memory loss in older people,3-6 but it is less certain whether long-term use increases the risk of dementia.
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