Some Meds May Impair Functioning
Seniors' ability to do daily tasks often slows as exposure increases

(HealthDay News) -- Older adults who take medicines that block a specific chemical messenger in the brain might need help with day-to-day activities.

That's the finding of recent studies examining the side effects of so-called anticholinergic medicines, a class of drugs used for a wide variety of conditions, including incontinence, dementia, high blood pressure and allergies.

"Because these medications are so commonly prescribed, older adults who take multiple medications are at increased risk of taking one or more anticholinergic-containing medications," Dr. Kaycee M. Sink, an assistant professor of medicine at Wake Forest University School of Medicine in Winston Salem, N.C., and a study author, said in a prepared statement. "The potential effects on physical function represent a significant public health problem," Sink added.

Anticholinergic drugs block the action of acetylcholine, a chemical messenger that helps nerve cells communicate, according to the Merck Manual of Health & Aging . Acetylcholine is involved in memory, learning and concentration, and also plays a role in the functioning of the heart, blood vessels, airways and organs of the urinary and digestive tract, it says.

Medications that are anticholinergic can interfere with normal functioning of these organs, the manual explains.

One study involved more than 3,000 adults whose average age was 78. Sink's team examined the effects of taking multiple anticholinergic drugs on the study participants' walking speed and their ability to function independently. About 40 percent took more than one anticholinergic drug.

People with higher anticholinergic exposure walked slower and were more likely to be dependent on others for help with other daily activities. The findings were presented at a meeting of the American Geriatrics Society.

"For older adults taking a moderately anticholinergic medication, or two or more mildly anticholinergic medications, their function was similar to that of someone three to four years older," noted Sink, who also serves as director of the Kulynych Memory Assessment Clinic at Wake Forest University Baptist Medical Center in Winston-Salem , N.C.

In another study, Sink and her colleagues found that older adults taking a combination of anticholinergic agents for dementia and incontinence had a 50 percent faster decline in functioning than those being treated only for dementia. The results were published in the Journal of the American Geriatrics Society .

There's also evidence that this class of drugs affects cognitive function.

Researchers at Yale University School of Medicine followed 500 men who were 65 and older and had high blood pressure. The men took tests to assess their short-term memory and "executive function" -- a term used to describe the ability to plan, organize and pay attention -- at the beginning of the study and a year later. Researchers used participants' medical records to assess total anticholinergic use.

Over the course of a year, the men showed deficits in memory and daily function when they took these medicines, the researchers found.

"This study extends our previous findings on acute cognitive impairment following recent anticholinergic exposure in older medical inpatients," co-author Dr. Ling Han, a senior epidemiologist and biostatistician with Yale's program on aging, said in a prepared statement.

"Prescribing for older adults who take multiple prescription and over-the-counter medications requires careful attention to minimize the risk of potential harms of the drugs while maximizing their health benefits," Han cautioned.

On the Web

To learn more about the side effects of medicine in older people, check out information from Brigham and Women's Hospital in Boston.

SOURCES: HealthDay News ; Wake Forest University School of Medicine, news releases, April 30 and May 3, 2008; Merck Manual of Health & Aging , Merck & Co., Inc., Whitehouse Station , N.J. ; Journal of the American Geriatrics Society , news release, Jan. 26, 2009
Author: Karen Pallarito
Publication Date: May 31, 2009
Copyright © 2009 ScoutNews, LLC. All rights reserved.