I came of age in the late 1960s, when recreational drug use was a sign of countercultural solidarity, so for several years I conformed to the expectations of my tribe. This led to some poor decision-making on my part (“Sure, let’s get high before careening down this mountain slope on skis”), choices that somehow did not produce fatal results. By the early ’80s, however, I’d thankfully outgrown the need to feel groovy and became gradually more suspicious of drugs in general.
These days, you might find a bottle of aspirin if you searched hard enough in our hall closet, but despite My Beleaguered Physician’s best efforts, I’ve managed to avoid the iron grip of Big Pharma. This makes me something of an outlier among my peers: Three out of four seniors take at least one prescription medication on a regular basis, according to a 2016 AARP survey. If I followed MBP’s advice, I’d be swallowing a statin to lower my cholesterol; some combo of diuretics, beta-blockers, and ACE inhibitors to reduce my blood pressure; and probably some pill to make me smart enough to listen to MBP’s advice.
Maybe it’s just dumb luck that I’m still vertical as I creep up on my eighth decade, but the more I read about the unintentional consequences of prescription-drug use, the more I’m persuaded that it’s not for me. Researchers from the University of Nottingham in England, for instance, recently released the results of a study suggesting that long-term use of popular anticholinergics may increase the risk of dementia.
These drugs — which include everything from bladder remedies and muscle relaxants to antidepressants and antihistamines — block acetycholine, a neurotransmitter that regulates several nervous-system functions. And because folks my age already tend to produce less acetycholine than we did when we were younger, these medications can create havoc in a geezer’s brain.
As Pam Belluck reports in the New York Times, Carol Coupland, PhD, and her University of Nottingham team reviewed the medical records of about 285,000 people 55 or older to determine the connection between anticholinergic drug use and dementia diagnoses. Some 59,000 members of this group had been diagnosed with dementia, so researchers looked at the drugs they had been taking in the decade prior to the diagnosis.
Adjusting for lifestyle behaviors, medical conditions, overall medication use, and other factors, Coupland’s team concluded that those who took a strong anticholinergic drug daily for about three years were 50 percent more likely to suffer from dementia than those who did not use the drugs. Antidepressants, bladder medications, antipsychotics, and epilepsy medications were implicated more strongly than antihistamines and other anticholinergics.
This was an observational study, Belluck notes. It doesn’t necessarily prove that taking these drugs caused dementia. “All it shows is that the risk of developing dementia appears to be higher for people who take some of the medications.”
It’s an important point for older folks who are less cavalier about their healthcare choices than I am. Even I’ll admit that antidepressants save lives every day and that properly diagnosed medications have extended lifespans for thousands of seniors. And, as Belluck points out, there may be options that don’t involve anticholinergics, so talk to your doctor. You get to choose.
And, for better or for worse, so do I. Maybe someday Big Pharma will develop a pill that persuades drug-averse geezers like me to actually follow their doctor’s advice. Good luck trying to get me to take it.