Cognitive adverse effects and brain deterioration associated with use of anticholinergic activity medicines in older adults

Context Older people are particularly vulnerable to adverse cognitive effects and risk of dementia following exposure to medicines with anticholinergic activity; 1 however, the biological basis for these effects remains unclear. 2 The risk of anticholinergic adverse effects increases with age, polypharmacy, comorbidities, pre-existing cognitive impairment, cholinergic neuronal degeneration and changes in pharmacokinetic and pharmacodynamic properties. A small sample size and retrospective analysis also limits causality. [...]agreeing with the authors, controlled prospective longitudinal studies are necessary to fully understand the true mechanism underlying the effect of exposure to anticholinergic activity medicines on the brain.