Anticholinergic drugs and dementia: a causal link?

The implications of changes to the regulation of oxybutynin in the UK and the case for deprescribing anticholinergics, such as this, to prevent cognitive adverse effects.

Anticholinergic drug use is on the rise. In England, there is evidence that anticholinergic burden of patients, particularly older people in care and nursing homes, increased markedly during the COVID-19 pandemic.

The UK medicines regulator is also considering extending access to the anticholinergic bladder drug oxybutynin over the counter, despite major concerns over its link with an increased risk of dementia.

In this episode of The PJ Pod, we will look at the potential implications of these changes, particularly in older people, and examine the case for deprescribing. We will also assess emerging evidence that suggests that the cumulative burden of anticholinergics over a lifetime could be a causal factor for dementia.

Thank you to Graham Stretch, chief pharmacist at the Argyle Group in west London, his patient Miriam* who agreed for us to record her consultation, and Chris Fox, professor of clinical psychiatry at the University of East Anglia.

This programme is presented by Nigel Praities, executive editor, and Julia Robinson, senior data journalist. It was produced by Geoff Marsh.

*Some details have been changed to ensure confidentiality.

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Last updated
The Pharmaceutical Journal, PJ, October 2022, Vol 309, No 7966;309(7966)::DOI:10.1211/PJ.2022.1.159081


  • David Taylor

    One of the leading researchers in this area is Delia Bishara, a pharmacist. Odd that she is not mentioned.

  • Anne Bentley

    What a great podcast! Recommended listening. Anticholinergic burden is important and often overlooked. Graham's team experience exactly mirrors what we found in East Lancashire - patients' quality of life improved with reduce drug burden. Clinicians inspired to deprescribe by witnessing positive patient outcomes. Good work!


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