NEW YORK (Reuters Health) - Elderly people taking anticholinergic drugs are at risk of developing deficits in cognitive functioning, even though their risk of dementia is not increased, French researchers report.

"Doctors should assess current use of anticholinergic drugs in elderly people with mild cognitive impairment before considering administration of acetylcholinesterase inhibitors," lead investigator Dr. Karen Ritchie and colleagues advise in their report, published in BMJ Online First on February 1.

The research team, based at Hopital La Colombiere in Montpellier, points out that many commonly prescribed drugs have anticholinergic properties, including "antiemetics, antispasmodics, bronchodilators, antiarrhythmic drugs, antihistamines, analgesics, antihypertensives, antiparkinsonian agents, corticosteroids, skeletal muscle relaxants, ulcer drugs and psychotropic drugs."

To evaluate the effects of anticholinergic drugs, Dr. Ritchie's team recruited patients aged over 60 years from general practices. Thirty patients had been using an anticholinergic drug for at least 1 year when they underwent neuropsychometric testing, and 297 had taken no anticholinergic drugs.

Mild cognitive impairment was diagnosed among 24 (80%) of those using anticholinergics and 105 (35%) of their counterparts. Specifically, anticholinergic users showed significantly worse performance on simple reaction time, attention, immediate and delayed visuospatial memory, narrative recall, and verbal fluency.

In a logistic regression model, only anticholinergic drug use (odds ratio 5.12) and age were significantly associated with cognitive impairment. Gender, education, untreated depression, and treated hypertension were not significantly associated with such impairment.

However, when the same subjects were followed up 8 years later, there was no difference between groups in the diagnosis of dementia. Therefore, the authors note, use of acetylcholinesterase inhibitors would be inappropriate for these subjects.

"Anticholinergic drugs should be considered as a possible reversible cause of mild cognitive impairment," Dr. Ritchie and her team conclude.

BMJ Online First 2006

Copyright © 2006 Reuters Limited. All rights reserved. Republication or redistribution of Reuters Limited content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters Limited. Reuters Limited shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.