Elderly warned of death risk from common drugs
http://dervishcom.blogspot.com/2011/06/elderly-warned-of-death-risk-from.html
It's not quite a case of "stop taking the pills", but the elderly should avoid any unnecessary drugs that block the neurotransmitter acetylcholine, researchers warned today.
As widely reported, they concluded after a 2-year study on 13,000 men and women over 65 that taking anticholinergic - acetylcholine-blocking - drugs raises the risk of death and dementia in the elderly. What makes the findings potentially alarming is that the offending drugs include many commonly prescribed, routine medications for hay fever, depression, heart health - and even eye drops for glaucoma.
The researchers rated the strength of the acetylcholine-blocking action for each drug on a scale from 0 (no effect) to 3 (severe effect). Using this scale, they investigated possible links between the combined strength of drugs that individual participants took and their chances of dying or developing dementia during the study. About half the participants were taking acetylcholine-blocking drugs, and the average rating score was 1.8.
The most alarming finding was in the 500 or so "heavy" users taking drugs with a combined rating of 4 or more. Twenty per cent of them died by the end of the study compared with only 7 per cent of those taking no anticholinergic drugs.
Likewise, participants taking drugs with a cumulative rating of 5 or more showed evidence of accelerated cognitive decline. They averaged scores 4 per cent lower than normal in cognitive function tests. You can see Chris Fox of the University of East Anglia, which led the study, interviewed here about the results.
For every additional point on the scale, the odds of dying rises by 26 per cent, the researchers conclude in the Journal of the American Geriatrics Society. The effects turned out to be cumulative, so the fewer medications people take, the lower the risk.
As reported by The Express, some of the drugs with ratings of "3" include chlorphenamine, the active ingredient in over-the-counter hay fever medications such as Piriton. Others include the "tricyclic" antidepressant amitriptyline and the incontinence drug oxybuynin.
David Nutt, president of the British Neuroscience Association and former head of the UK government's advisory committee on drug misuse, is quoted in the Financial Times as advising pensioners to shift from using "tricyclic" antidepressants to selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) and paroxetine (Seroxat).
The researchers say that pensioners shouldn't panic, and shouldn't stop taking any medications without first consulting their family doctors about it. One of the researchers, Ian Maidment of the University of Cambridge, recommends in an article in The Telegraph that people stop taking any offending medications that are not absolutely necessary.
Likewise, an article in Pulse urges family doctors to be ready to review anticholinergic medications that their elderly patients are on, to see if any can be safely halted.
As widely reported, they concluded after a 2-year study on 13,000 men and women over 65 that taking anticholinergic - acetylcholine-blocking - drugs raises the risk of death and dementia in the elderly. What makes the findings potentially alarming is that the offending drugs include many commonly prescribed, routine medications for hay fever, depression, heart health - and even eye drops for glaucoma.
The researchers rated the strength of the acetylcholine-blocking action for each drug on a scale from 0 (no effect) to 3 (severe effect). Using this scale, they investigated possible links between the combined strength of drugs that individual participants took and their chances of dying or developing dementia during the study. About half the participants were taking acetylcholine-blocking drugs, and the average rating score was 1.8.
The most alarming finding was in the 500 or so "heavy" users taking drugs with a combined rating of 4 or more. Twenty per cent of them died by the end of the study compared with only 7 per cent of those taking no anticholinergic drugs.
Likewise, participants taking drugs with a cumulative rating of 5 or more showed evidence of accelerated cognitive decline. They averaged scores 4 per cent lower than normal in cognitive function tests. You can see Chris Fox of the University of East Anglia, which led the study, interviewed here about the results.
For every additional point on the scale, the odds of dying rises by 26 per cent, the researchers conclude in the Journal of the American Geriatrics Society. The effects turned out to be cumulative, so the fewer medications people take, the lower the risk.
As reported by The Express, some of the drugs with ratings of "3" include chlorphenamine, the active ingredient in over-the-counter hay fever medications such as Piriton. Others include the "tricyclic" antidepressant amitriptyline and the incontinence drug oxybuynin.
David Nutt, president of the British Neuroscience Association and former head of the UK government's advisory committee on drug misuse, is quoted in the Financial Times as advising pensioners to shift from using "tricyclic" antidepressants to selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) and paroxetine (Seroxat).
The researchers say that pensioners shouldn't panic, and shouldn't stop taking any medications without first consulting their family doctors about it. One of the researchers, Ian Maidment of the University of Cambridge, recommends in an article in The Telegraph that people stop taking any offending medications that are not absolutely necessary.
Likewise, an article in Pulse urges family doctors to be ready to review anticholinergic medications that their elderly patients are on, to see if any can be safely halted.
