Multiple medications new risk for elderly
Friday June 24th, 2011
Elderly people may be unwittingly overdosing on drugs, leading to dementia and death, researchers warned today.
Taking too many of the drugs, which are used for treating pain, asthma
and the heart, may treble the risk of dying, according to the study conducted
by two universities in East Anglia, UK.
The research involves drugs with what are known as anticholinergic and these include common pain-killers such as Codeine and antihistamines such as Chlorphenamine.
Anti-depressants, tranquilisers, bladder medication and some drugs for glaucoma and epilepsy may all have this effect.
An analysis of more than 13,000 people over the age of 65 found that 20 per cent died within two years if they were taking large doses of these drugs. This compared with seven per cent of those taking none of them.
The researchers say many patients may end up being prescribed anticholinergics for multiple conditions.
Researcher Professor Carol Brayne, of Cambridge University, UK, said: “It is important to scrutinise medications given to older people very carefully to try to minimise harm as well as gain the desired benefit.
"The admirable wish to give the best possible treatment with good evidence for individual conditions has to be balanced against the fact that in many older people with multiple conditions this will lead to accumulated risk such as that shown by this scale.”
Fellow researcher Dr Chris Fox, of the University of East Anglia, UK, said: “This is the first large scale study into the long-term impact of medicines which block acetylcholine - a common brain neurotransmitter - on humans, and our results show a potentially serious effect on mortality.
"Clinicians should conduct regular reviews of the medication taken by their older patients, both prescribed and over the counter, and wherever possible avoid prescribing multiple drugs with anticholinergic effects."
Dr Susanne Sorensen, of the UK's Alzheimer’s Society, said: "This robust study provides valuable findings, and must be taken seriously. However it is vital that people do not panic or stop taking their medication without consulting their GP.
We would urge people to have regular appointments with their doctor to review all drug treatments they are taking. This will help ensure they are on the best medications for their conditions, and that any side effects have been taken into consideration.”
* The researchers say the groups with the greatest impact include: anti-depressants such as Amitriptyline, Imipramine and Clomipramine; tranquilisers such as Chlorpromazine and Trifluoperazine; bladder medication such as Oxybutynin; and antihistamines such as Chlorphenamine.
Other drugs with an anticholinergic effect include: Atenolol, Furosemide and Nifedipine for heart problems; painkillers such as Codeine and Dextropropoxyphene; the asthma treatment Beclometasone; the epilepsy treatment Carbamazepine; and Timolol eyedrops which are used for glaucoma.
Anticholinergic medication use and cognitive impairment in the older population: The Medical Research Council Cognitive Function and Ageing Study (CFAS). C Fox (UEA), K Richardson (University of Cambridge), I Maidment (Kent and Medway NHS and Social Care Partnership Trust), G Savva (University of Cambridge), F Matthews (MRC Biostatistics Unit), D Smithard (Kent Community Health NHS Trust), S Coulton (University of Kent), C Katona (University College London), M Boustani (Indiana University), and C Brayne (University of Cambridge). Journal of the American Geriatrics Society June 24 2011.
Tags: Brain & Neurology | Elderly Health | North America | Pharmaceuticals | UK News
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