Frequent consumption of a common drug that acts on the nervous system and treats a range of ailments may lead to faster ageing in older adults, a new study says.
The study, published in JAMA Open Network, concludes that high exposure to anticholinergic drugs used for treating chronic obstructive pulmonary disease, bladder illnesses and Parkinson’s is associated with a faster decline in physical performance in older age.
Anticholinergic drugs block the action of the nerve-to-nerve signalling molecule acetylcholine, which plays a key role in the functioning of the nervous system. By inhibiting acetylcholine, these drugs affect several key bodily functions controlled by the nervous system. Their sedative and cognitive adverse effects, though, can be reversed with discontinuation.
It is not completely clear if their prolonged use is linked to sustained reduced physical function, researchers say.
Previous studies indicate that regular consumption of anticholinergics may have a constant effect over time, meaning all past exposure may show the same effect on the current risk of physical decline.
The latest study assesses the effects of cumulative exposure to the drugs over a decade, accounting for varying intensity, duration and timing of past intake.
Researchers monitored changes in walking speed and grip strength of over 4,000 older adults over time and compared this with their exposure to anticholinergic medications based on data collected from February 1994 to March 2020. While grip strength appeared unaffected, a higher exposure to anticholinergics was linked to a greater decline in walking speed.
“Higher anticholinergic exposure was associated with accelerated decline in physical performance,” scientists wrote.
“The accumulation of loss over time can become clinically meaningful.”
These findings are significant as frailty and changes in balance and gait are increasingly linked to multiple measures of poor health outcomes, including disability and mortality.
Researchers call for minimising the prescription of anticholinergic medication to promote healthy ageing.
“We provide novel findings by considering time-varying anticholinergic exposure and examining the annual change rate of physical performance,” they wrote in the study. “Anticholinergics are associated with numerous adverse outcomes in older adults. Therefore, it is essential for clinicians to avoid their use whenever possible, prescribe the lowest effective dose and periodically reevaluate patients to identify de-prescribing opportunities to minimise potential harms.”
