Do Anticholinergic Drugs Up Dementia Risk in PD Patients?

Anticholinergics Tx in Parkinson's may not increase dementia risk
Anticholinergics Tx in Parkinson's may not increase dementia risk

Findings from a recent study challenge existing evidence of an increased risk of dementia, particularly Alzheimer's disease, in patients taking anticholinergic medications. The study is published in the current issue of the Journal of Parkinson's Disease.   

Anticholinergics are typically used by older adults to treat bladder dysfunction, mood, and pain, and many are available without prescription. Patients with Parkinson's disease use anticholinergics to treat both motor and non-motor symptoms and may be at risk of dementia.

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The new study, however, found that cognitive performance of patients with Parkinson's disease taking anticholinergics did not differ from those who did not. Researchers from Newcastle University, UK, used data from the Incidence of Cognitive Impairment in Cohorts with Longitudinal Evaluation - Parkinson's Disease study (ICICLE-PD), that included 195 patients with Parkinson's disease (PD) and 84 controls. The patients' medication history, including over-the-counter (OTC) drugs, was assessed according to the Anticholinergic Drug Scale (ADS). 

Every drug was categorized according to no (0), mild (1), moderate (2), or high (3) anticholinergic activity. The total burden score was calculated based on total usage from baseline to 18-month follow-up. Patients with ADS scores ≥1 were in the PD+ADS group while patients with ADS scores of 0 were classified as PD-ADS. 

Researchers found no differences in global cognition or assessments of attention, memory, and executive function at 18 months between the PD+ADS (n=83) and PD-ADS (n=112) groups. They also noted the proportion of mild cognitive impairment (MCI) was similar in those with and without anticholinergic drug use. The total drug burden did not differ between the two groups although a higher proportion of Parkinson's disease patients were taking anticholinergic drugs. 

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