Common drugs hasten decline in elderly: study

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 on Saturday.

They 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.

She said in many cases newer drugs are available that do not have these effects and said doctors should look out for them for elderly patients.

MEMORY DECLINE

Dr. Jack Tsao, a neurologist with the U.S. Navy, reported last month at an 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.

Sink studied the effects of taking multiple anticholinergic drugs on walking speed, basic activities such as dressing, eating, taking care of personal hygiene, grooming, and harder activities like shopping, cooking and managing money on her test subjects whose average age was 78.

The researchers found that the more anticholinergic drugs people had in their systems, the worse their physical function, based on reports from people in the study and on independent measures of their performance.

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.”