MEDICATIONS taken by thousands of Brits for to treat an overactive bladder have been linked to dementia in a new study.
Some forms of the medication have been found to raise the risk of dementia by about a third.
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Anticholinergics are a class of drugs that block the activity of acetylcholine, a chemical messenger in the brain and body that helps transmit signals between nerves and muscles.
They’re used to treat a variety of conditions, including overactive bladder – a condition that affects over 4.5 million people in the UK, according to the NHS.
For an overactive bladder they work by reducing the activity of certain muscles to stop the bladder contracting.
This reduces the frequency of bladder contractions, which in turn reduces the urge to urinate.
But new research involving one million Brits has suggested the pills could raise the risk of dementia by about a third.
British scientists looked at health data from 170,742 patients in England over the age of 55 with dementia and compared them to 800,000 patients without the condition.
It was found taking an anticholinergic could increase the risk of a dementia diagnosis by 18 per cent.
The elevated risk was also shown to be slightly higher in men (22 per cent) compared to women (16 per cent).
It was also discovered specific types of the drugs could carry a much higher risk.
Those prescribed oxybutynin hydrochloride had a 31 per cent higher risk of developing the condition.
Those taking tolterodine tartrate showed a 27 per cent increased risk.
But the research, published in the British Medical Journal, found some types of anticholinergics didn’t raise the risk of dementia.
This included:
- darifenacin
- fesoterodine fumarate
- flavoxate hydrochloride
- propiverine hydrochloride
- trospium chloride
The researchers concluded clinicians need to “take into account the possible long term risks and consequences of the available treatment options for an overactive bladder in older adults”.
Also, that doctors should “consider prescribing alternative treatment that might be associated with a lower risk of dementia”.
The experts did analyse a non-anticholinergic drug called mirabegron, which is also prescribed to patients with overactive bladders.
Unlike anticholinergics, mirabegron works by activating beta-3 adrenergic receptors in the bladder, causing the bladder muscle to relax and increase its capacity to store urine.
While there was some evidence of links to dementia, the scientists noted the data wasn’t clear and further research is required.
How the study was carried out
The 170,742 Brits with dementia who formed part of the study’s analysis had taken an anticholinergic drug or mirabegron for three to 16 years before their dementia diagnosis.
Each Brit with dementia was then matched with a participant from the 800,000 strong control group, in relation to their exact age, sex and GP practice.
But the study did have a number of limitations – one of which was data for exact dosage given to patients was lacking, meaning the authors couldn’t fully explore if higher doses of some drugs led to an increased risk of dementia over time.
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Why can anticholinergics contribute to dementia?
Exactly how the drugs affect the brain isn’t fully understood.
But it’s thought anticholinergics can contribute to dementia because they block the action of acetylcholine, a neurotransmitter crucial for memory and cognitive function in the brain.
Previous studies have also linked anticholinergics to dementia.
A study published in 2018 in the BMJ found long-term use of anticholinergics for depression, and also Parkinson’s disease (such as procyclidine) and loss of bladder control (for example, oxybutynin, solifenacin, and tolterodine) was linked to higher risk of dementia.
A study published in 2019 also found exposure to several types of strong anticholinergic drugs is associated with an increased risk of dementia.
The researchers said the findings highlighted the importance of reducing exposure to anticholinergic drugs in midddle-aged and older people.
A doctor recently revealed five common drugs could raise your risk of dementia.
How to reduce your risk of dementia
There are a number of things you can do to reduce your risk of developing dementia. Alzheimer’s Society offers the following tips:
Do regular physical exercise
Regular physical activity is considered one of the best ways to reduce your risk of dementia. There are two main types – aerobic activity and strength-building activity. Aerobic activity includes activities like brisk walking, running and swimming. Strength-building include exercises like squats and push-ups. A combination of both types of activity is best.
Drink less alcohol
Drinking too much alcohol exposes your brain to high levels of harmful chemicals. You should avoid drinking more than 14 units of alcohol each week. This is the equivalent of one pint of beer and a small glass of wine each day.
Don’t smoke
Smoking harms the circulation of blood around, particularly blood vessels in the brain. The earlier you stop smoking, the more brain damage you’ll avoid.
Stay mentally well and socially active
People who have periods of depression and are socially isolated are at higher risk of developing dementia. Engaging
in social activities can help build up your brain’s ability to relieve stress and improve your mood.
Manage long-term health conditions
Certain health conditions, such as high blood pressure, high cholesterol and diabetes can increase the risk of getting dementia. Going for a health check to see if you have any of these is advised. Eating well and regularly exercising can help prevent and manage these conditions.
Protect your eyesight and hearing
Uncorrected vision loss can increase the risk of dementia. Similarly, hearing loss is tied to increased risk of dementia and could be an early symptom. The use of hearing aids has been shown to reduce the risk of dementia to the level of a person with normal hearing.
Protect your head
Traumatic brain injuries caused by a blow or jolt to the head, particularly when a person is knocked unconscious, can start a process in the brain where the substances that cause Alzheimer’s disease build up around the injured area. If you’re in a situation where there’s higher-than-normal risk of head injury, such as riding a bike or playing cricket, make sure to wear protective headgear.
