How some medicines cause side effects that imitate dementia in the elderly, and safer alternatives
- Insomnia, incontinence and Parkinson’s disease are common in the elderly, and are often treated with medicines called anticholinergics
- Studies show that these drugs impair old people’s cognitive functions; fortunately, alternative drugs are available
By all accounts the woman, in her late sixties, appeared to have severe dementia. She was largely incoherent. Her short-term memory was terrible and she couldn’t focus on questions that medical professionals asked her.
But Malaz Boustani, a doctor and professor of ageing research at Indiana University School of Medicine, suspected something else might be going on. The patient was taking Benadryl for seasonal allergies, another antihistamine for itching, Seroquel (an antipsychotic medication) for mood fluctuations, as well as medications for urinary incontinence and gastrointestinal upset.
To various degrees, each of these drugs blocks an important chemical messenger in the brain, acetylcholine. Boustani thought the cumulative impact might be causing her cognitive difficulties.
He was right. Over six months, Boustani and a pharmacist took the patient off the medications and substituted alternative treatments. Miraculously, she appeared to recover completely. Her initial score on the Mini-Mental State Examination had been 11 out of 30 – signifying severe dementia – and it shot up to 28, in the normal range.
An estimated one in four older adults take anticholinergic drugs – a wide-ranging class of medications used to treat allergies, insomnia, leaky bladder, diarrhoea, dizziness, motion sickness, asthma, Parkinson’s disease, chronic obstructive pulmonary disease and various psychiatric disorders.