Do you know how many medications your aging loved one is taking each month? On average, those aged 65+ take between 14-18 individual medications each year. With all of those medications, the risk of side effects greatly increases. Most surprisingly, recent studies have found that taking certain medications can put you at greater risk of dementia and other cognitive issues (source). For example, one study found that those taking certain medication to treat common diseases like asthma, muscular spasms, incontinence and even depression and sleep disorders for the equivalent of 3+ years saw an increased risk of dementia by 54% (source). These medications often have the same drug in them called Anticholinergics.
Why Do Medications Affect Older Adults Differently?
As we age, our brains change naturally. These natural changes, both in structure and ability, will impact how medications affect our body and brain health. How medications are metabolized throughout the body are also impacted because our digestive and circulatory systems change as we age. Finally, chronic health conditions (with 80% of older adults having at least one) can greatly complicate the side effects of over-the-counter and prescription medications (source). Examples of symptoms (or side effects) of medications on older adults include:
- Fatigue
- Confusion
- Agitation
- Falling
- Dizziness
- Constipation
- Blurred vision
- Depression
What are Anticholinergics?
Anticholinergics are drugs that block acetylcholine, a key neurotransmitter in the body. This leads to lower brain function, which people often experience as drowsiness. Acetylcholine serves as a messenger in the body that supports memory production and cognitive function (source). Common examples of anticholinergic drugs include: Benadryl, Demerol, Dimetapp, Dramamine, Paxil, Unisom and VESIcare. These are very common drugs and hard to avoid. You need to be vigilant and discuss with your physician if you take any of these medications so you avoid over stimulation of Anticholinergics.
Common Types of Anticholinergic Medications
You should discuss the list of medications below with your physician if you actively or intend to use them for:
Alleviating allergies or colds: Anticholinergics; brompheniramine (Dimetapp); carbinoxamine (Palgic); chlorpheniramine (Chlor-Trimeton); diphenhydramine (Benadryl); hydroxyzine (Atarax, Vistaril)
Reducing or managing anxiety and depression: Benzodiazepines; alprazolam (Xanax); chlordiazepoxide (Librium); clonazepam (Klonopin); clorazepate (Tranxene); Anticholinergics; amitriptyline (Elavil); clomipramine (Anafranil); doxepin (Sinequan)
Calming or controlling an over-active bladder: Oxybutynin (Ditropan); tolterodine (Detrol)
Medications for itching: hydroxyzine (Vistaril); diphendyramine (Benadryl)
Medications for nerve pain: amitriptyline; nortriptyline.
Muscle Relaxants: Cyclobenzaprine (Flexeril)
So what can you do with all of this information? As a Caregiver, make sure to tell your loved one’s physician about any and all medications prescribed by other specialists, as well as non-prescription or other over-the-counter medicines they take to address potential complications. Also, be careful to not misdiagnose side effects as normal cognitive changes. If you notice any behavioral changes in your aging loved one, discuss those changes directly with a physician. Do an inventory of all of the medications being used, check them against the list above and take action and discuss with your physician.
