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Anticholinergic drug use and risk for dementia: target for dementia prevention

Abstract

An increasing number of longitudinal cohort studies have identified a risk increase for dementia by the chronic use of drugs with anticholinergic properties. The respective data from the German Study on Aging, Cognition and Dementia in Primary Care Patients (AgeCoDe) also showing risk increase (hazard ratio = 2.081) are reported here. The mechanisms by which the risk increase is transported are still unknown. Irritation of compensated alterations of cholinergic transmission at the pre-dementia stage of Alzheimer’s disease (AD) or acceleration of neuroinflammation by disturbance of the anti-inflammatory effect of cholinergic innervation are discussed. In terms of dementia prevention, centrally acting anticholinergic drugs should be strictly avoided, because of long-term dementia risk increase in addition to acute negative effects on cognition.

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Acknowledgments

The study was supported by the German Competence Network on Dementia (CND) and by the German Competence Network on Degenerative Dementias (CNDD) funded by the German Federal Ministry for Education and Research (grants: O1GI 0102, 01 GI 0710, 01 GI 0711, 01 GI 0712, 01 GI 0713, 01 GI 0714, 01 GI 0715, 01 GI 0716, 01 GI 0717) and the Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, BfArM) grant: V-9909/68502/2008.

Conflict of interest

Frank Jessen has received research grants respectively from, is member of the Advisory Boards of, or draws a fee for speech from the following companies: Pfizer, Esai, Janssen Cilag, Novarits, Talecris, Altana Pharma, Octapharma, Merz, and AC Immune.

Horst Bickel has received research support from Organon and Dr. Wilmar Schwabe and fees for lectures from Bayer, Merz, Lundbeck, Dr. Wilmar Schwabe, and Wyeth.

Siegfried Weyerer has received research grants or draws a fee for speech from the following companies: AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Janssen Cilag, Novartis, Pfizer, and Wyeth.

Wolfgang Maier has received research grants respectively from, is member of the Advisory Boards, or draws a fee for speech from the following companies: AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Janssen Cilag, Lundbeck, Merck, Pfizer, Sanofi Aventis, Schering, and Böhringer.

Moritz Daerr, Karl Broich, Michael Pentzek, Steffi Riedel-Heller, Michael Wagner, Birgitt Wiese, Hendrik van den Bussche, and Hanna Kaduszkiewicz declare that they do not have any conflict of interest.

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Correspondence to Frank Jessen.

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Frank Jessen and Hanna Kaduszkiewicz equally contributed to this work.

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Jessen, F., Kaduszkiewicz, H., Daerr, M. et al. Anticholinergic drug use and risk for dementia: target for dementia prevention. Eur Arch Psychiatry Clin Neurosci 260, 111–115 (2010). https://doi.org/10.1007/s00406-010-0156-4

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  • DOI: https://doi.org/10.1007/s00406-010-0156-4

Keywords

  • Dementia
  • Risk
  • Anticholinergic drugs