Commonly used medications associated with impaired physical function in older adults

May 4, 2008

Older adults who take drugs designed to block the neurotransmitter acetylcholine – including common medications for incontinence, high blood pressure and allergies – are more likely to be dependent in one or more activities of daily living and to walk slower, according to new findings from researchers at Wake Forest University School of Medicine and colleagues.

The findings, which involve a class of drugs known as anticholinergic medications, are from the Ginkgo Evaluation of Memory Study (GEMS) and will be presented at the American Geriatrics Society Meeting in Washington, D.C., on May 3.

“These results were true even in older adults who have normal memory and thinking abilities,” said Kaycee M. Sink, M.D., M.A.S., lead author. “For older adults taking a moderately anticholinergic medication, or two or more mildly anticholinergic medications, their function was similar to that of someone three to four years older.”

In a separate study reported this month in the Journal of the American Geriatrics Society, Sink found that older nursing home residents who took medications for dementia and anticholingeric medications for incontinence at the same time had a 50 percent faster decline in function than those who were being treated only for dementia.

Over a year’s time, the decline would represent a resident going from requiring only limited assistance in an activity to being completely dependent, or from requiring only supervision to requiring extensive assistance in an activity.

Sink said that the two studies together suggest that physicians should carefully consider the implications when prescribing anticholingeric medications to older adults.

“Because these medications are so commonly prescribed, older adults who take multiple medications are at increased risk of taking one or more anticholinergic-containing medications,” said Sink. “The potential effects on physical function represent a significant public health problem.”

Many medications have anticholinergic properties including some for high blood pressure, some antidepressants, most allergy medicines and incontinence medicines. Some of the most common anticholinergics in the GEMS participants include the blood pressure medication nifedipine (Adalat® or Procardia®), which has mild anticholinergic properties, the stomach antacid ranitidine (Zantac®), which has moderate anticholinergic properties, and the incontinence medication tolterodine (Detrol®), which is highly anticholinergic.

In the GEMS study, the researchers sought to determine the effects of taking multiple anticholinergic drugs on walking speed and the ability to independently perform activities of daily living such as dressing, personal hygiene, toileting, transferring, bed mobility and eating as well as higher order activities including shopping, cooking, managing money, doing light housework and using a telephone.

The findings are from more than 3,000 people with an average age of 78 years. Almost half (40 percent) of participants were taking more than one anticholinergic drug. The researchers found that higher anticholinergic burden is associated with worse physical function, both self-reported and performance-based.

Source: Wake Forest University Baptist Medical Center

Explore further: Anticholinergics may not be best choice for rehab patients with dementia

Related Stories

Are medications' adverse cognitive effects reversible?

January 26, 2015

Whether the adverse cognitive effects of medications can be reversed is of significant importance to an aging population, their caregivers and their families, as well as to an overburdened health care system.

Recommended for you

Artificial beta cells

December 8, 2016

Researchers led by ETH Professor Martin Fussenegger at the Department of Biosystems Science and Engineering (D-BSSE) in Basel have produced artificial beta cells using a straightforward engineering approach.

Key regulator of bone development identified

December 8, 2016

Loss of a key protein leads to defects in skeletal development including reduced bone density and a shortening of the fingers and toes—a condition known as brachydactyly. The discovery was made by researchers at Penn State ...

Researchers question lifelong immunity to toxoplasmosis

December 8, 2016

Medical students are taught that once infected with Toxoplasma gondii—the "cat parasite"—then you're protected from reinfection for the rest of your life. This dogma should be questioned, argue researchers in an Opinion ...

TET proteins drive early neurogenesis

December 7, 2016

The fate of stem cells is determined by series of choices that sequentially narrow their available options until stem cells' offspring have found their station and purpose in the body. Their decisions are guided in part by ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.