Antivertigo/Antimimetic Anticholinergics and Dementia
Exposure to Anticholinergic Drugs is Associated with Increased Dementia Risk
Anticholinergic medications have long been known to have adverse cognitive effects in the short-term. However, the association between Anticholinergics (e.g., antivertigo/antimimetic such as Dramamine®, Compro®, and Phenergan®) over long-term use and Dementia has not previously been evaluated. Coupland et al., (2019), examined the link between anticholinergic medication and dementia. They examined long-term use of anticholinergic medication for a variety of common medication types (e.g., antivertigo/antimimetics). In a sample of 58,769 patients matched for age, sex, general practice, and calendar time (control participant selected when the active patient was diagnosed). The researchers looked at a 10-year period ending 1 year before the diagnosis of dementia. For patients with long term exposure to anticholinergics for antivertigo, the adjusted odds ratio was 1.47. This means that for patients who got anticholinergics for vertigo, the odds of dementia were 47% higher than those who did not receive anticholinergics.
“We found greater increases in risk associated with people diagnosed with dementia before the age of 80, which indicates that anticholinergic drugs should be prescribed with caution in middle-aged and older people.” p. E9
Medication has its role in immediately remedying symptoms for a patient, but in the case of anticholinergic medication-management of vertigo, there are real risks with prolonged use. When prescribing medication for urinary incontinence, consider a concurrent prescription for Vestibular Rehabilitation. Vestibular Rehabilitation by a Physical Therapist has no known adverse effects and may reduce the need for anticholinergic medication, thus reducing the increased risk of Dementia onset.
Submitted by Dr. Lauren Collier Peterson, PT, DPT
Clinical Director FYZICAL Therapy & Balance Centers of Oklahoma City
Dr. Peterson and her staff provide Physical Therapy for patients with pelvic floor dysfunction, imbalance and falls risk, & orthopedic injuries in OKC.
She has treated hundreds of men and women with pelvic floor issues ranging from incontinence and constipation to pain and prolapse. While she has a particular clinical interest in pelvic pain disorders, she wants everyone to enjoy good pelvic health and to know that “Leaks are not normal!”
Coupland, C.A.C., et al. (2019). Anticholinergic drug exposure and the risk of dementia: A nested case-control study. JAMA Internal Medicine, E1-E10.