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

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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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Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, University of Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany

    Frank Jessen, Moritz Daerr, Michael Wagner & Wolfgang Maier

  2. Department of Primary Medical Care, University Medical Center, Hamburg-Eppendorf, Germany

    Hanna Kaduszkiewicz & Hendrik van den Bussche

  3. Department of Psychiatry and Psychotherapy, Technical University, Munich, Germany

    Horst Bickel

  4. Department of General Practice, University of Dusseldorf, Medical Faculty, Dusseldorf, Germany

    Michael Pentzek

  5. Institute of Social Medicine and Occupational Health, University of Leipzig, Leipzig, Germany

    Steffi Riedel-Heller

  6. Psychiatric Epidemiology and Demographic Change, Central Institute of Mental Health Mannheim, Mannheim, Germany

    Siegfried Weyerer

  7. Institute for Biometrics, Hannover Medical School, Hannover, Germany

    Birgitt Wiese

  8. Federal Institute for Drugs and Medical Devices, Bonn, Germany

    Karl Broich

Authors
  1. Frank Jessen
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  2. Hanna Kaduszkiewicz
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  3. Moritz Daerr
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  4. Horst Bickel
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  6. Steffi Riedel-Heller
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  8. Siegfried Weyerer
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  9. Birgitt Wiese
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  10. Hendrik van den Bussche
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  12. Wolfgang Maier
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Corresponding author

Correspondence to Frank Jessen.

Additional information

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 (Suppl 2), 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

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