Medications Cause Slowness, Need for More Care in Older Adults
Doctors are being warned that the drugs they select for their older patients could result in slower physical function and even increased dependency on a caregiver to perform otherwise routine functions. The drugs that are causing this slowed physical action to occur are commonly prescribed for high blood pressure, depression, allergies and incontinence.
A variety of drugs that doctors prescribe for these problems fall into a class known as anticholinergic medications. These drugs work to block the neurotransmitter acetylcholine. This substance affects the way nerve impulses are transmitted, thus producing such effects as reduced blood pressure or lesser symptoms of depression. Some are used to control allergies or stomach acid and others to reduce incontinence.
A recent study found that these medications are producing undesirable effects on older persons. One of the very noticeable changes is that older people taking these medications are walking more slowly. In essence, many are behaving in a way that would be characteristic of a person who is several years older than their current chronological age.
“These results were true even in older adults who have normal memory and thinking abilities,” said Kaycee M. Sink, M.D., lead author of the study recently completed at the Wake Forest University School of Medicine. “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.”
Generally, blood pressure medications have a mild level of anticholinergic properties. Antacids would have a higher amount, and incontinence medications would be very high in the blocker. In the study of more than 3,000 persons with an average age of 78 years, 40 percent of the participants were taking more than one anticholinergic drug.
In another study, researchers found that patients who received dementia drugs and medication for incontinence at the same time had a 50 percent faster decline in their functions than did persons who were being treated only for dementia. “Over a year’s time, the decline we observed 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,” said Dr. Sink.
The two most common medical conditions in nursing homes for which drugs are given have to do with dementia and urinary incontinence. Caregivers who are responsible for aging parents or loved ones in a nursing home would be wise to check with the person’s physician regarding prescriptions for these two conditions. If anticholinergic medications and dementia medicines are both being prescribed, there is a very good chance that the aging process of the patient will be rapidly accelerated, according to the results of this study.