Sedatives and anticholinergic medicines affect the cognition of older adult users. A new study looked at the link between the drug burden index from taking the medicines along with the effects on cognition. Overall, the higher the drug burden was, the lower processing speed and general cognitive problems people taking the drugs had. The report was published April 3 in The Journals of Gerontology.
Anticholinergic medications block and stop the activity of the neurotransmitter acetylcholine (ACh) in the central and peripheral nervous system. The drugs can be used to treat people with urinary incontinence, Parkinson’s disease, respiratory disorders, cardiovascular disease and more.
Researchers used the Modified Mini-Mental State Examination (3MS) and the Digit Symbol Substitution Test (DSST) to evaluate the impact of the drugs on the older adults studied.
Data came from 3,075 men and women who were part of the Health, Aging, and Body Composition Study. All of the people were community-dwelling adults between 70 and 79 years old when the study began. Researchers utilized data from the first year of the study, as well as five and 10 years into the study.
The investigators calculated the drug burden index for each person based on the medications they were taking. Data was adjusted based on different factors such as sex, race, education level, apolipoprotein E (APOE) gene (which is associated with cognitive decline), and whether or not a person died.
The drug burden was linked to 3MS and DSST scores, and the associations became stronger every year. In other words, when older adults had higher drug burden index they had lower global cognition and processing speed. Authors of the report say that the drug burden index is a useful tool to evaluate the effects that medications have on older adults.
A study that was published in 2020 found that long-term exposure to anticholinergic and sedative medications was tied to lower physical function. That study used data on more than 4,600 nursing home residents between June 2005 and April 2014. People with higher drug burden index scores had lower activities of daily living scores. That team didn’t find a tie with poorer cognitive function.
