Mind Your Meds

Mind Your Meds

CAN SOME COMMONLY USED MEDICATIONS CAUSE COGNITIVE DECLINE OR DEMENTIA? STUDIES BY UEA SCIENTISTS ARE FINDING OUT THE RISKS AND BENEFITS OF PRESCRIBING CERTAIN MEDICATIONS TO OLDER PEOPLE.

Psychiatrist Prof Chris Fox (Norwich Medical School) and statistician George Savva (School of Health Sciences) from the University of East Anglia have joined forces to set up the ‘ABCD’ study (Anticholinergics, Benzodiazepines, Cognition and Dementia). 

Through the careful analysis of data on medication use and brain health, the study looks at how sleeping medications and other common drugs affect older people, specifically their impact on cognitive decline and dementia. Findings from the study will inform an evidence-based method of prescribing, based on the principles of patient-centred care.

The study looks at the effects of medication with anticholinergic effects (used to treat diseases like incontinence, depression and sleep disorders), benzodiazepines (a class of medications used for sleep and anxiety, including familiar names such as Valium and Xanax) and other sleeping medications. 

Over 100 common drugs have side effects such as falls and cognitive impairment, and many older people are taking a concoction of drugs over a prolonged period. This can present busy GPs with a challenge when it comes to weighing up the benefits and the risks of certain medications. 

Whilst many of these medications might help an individual manage the symptoms of insomnia, anxiety, depression or incontinence, they could have severe consequences in the longer term. A fall can be a red flag, which often implies something a lot more serious but is rarely recognised as life-threatening. A hip fracture, for example, has an 8-10% mortality rate – similar to that of a heart attack or a stroke. 

“There are four conditions which our work has shown could increase due to the use of anticholinergic medicines: falls, potential death, cognitive impairment and delirium” says Prof Chris Fox.

Clinicians need more information to help them make evidence-based decisions for patients, based on their individual needs and lifestyle. By giving the patient the right information, the GP and their patient can make informed decisions on benefits versus risk. 

The results of this study could have a huge impact over the next ten years as the NHS seeks to improve the quality of life for older people. With a growing elderly population, and increased pressure on the NHS, the study will help to bring about a better way to manage prescriptions for older people, focusing on the individual patient’s needs. 

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