The long-term use of anticholinergic drugs is associated with an increased risk of fractures and dementia in elderly people, a study conducted by Chen Liang-kung (陳亮恭), director of the Center of Geriatrics and Gerontology at Taipei Veterans General Hospital, and other researchers showed.
Using the National Health Insurance database, the research team analyzed medical records from 2002 to 2011 of 110,000 people aged 65 or older, Chen said on Saturday.
The records showed that the use of medications has increased, Chen said, adding that on average, over 10 years, each person was taking one to two additional medications for chronic conditions.
The study, which has been published in the Annals of Family Medicine, showed that the more medications an elderly person took, the more anticholinergic effects were exhibited.
Anticholinergic substances block neurotransmitters in the central and the peripheral nervous system.
Those who used the most medications with anticholinergic effects showed a 71 percent higher risk of fractures than those who did not take the medications, the study said.
Their risk of developing dementia was also several times higher, it said.
Elderly people in Taiwan like to make hospital visits and take medication, but concurrent use of multiple prescription medications has become a serious problem, Chen said.
Although the issue of duplicate prescriptions has been reduced with the introduction of cloud-based medical records, elderly people on average still take 2,045 pills per year, or five or six per day, Chen said, citing National Health Insurance Administration statistics.
Elderly people tend to have more comorbid conditions and almost every condition requires medication, he said.
When one condition leads to headaches or other side effects, they often seek help from a specialist in a different department, resulting in more medication, he said.
However, nearly 30 percent of the prescription drugs that elderly people commonly use have anticholinergic effects, he said.
The top three most frequently used medications with strong anticholinergic effects are antihistamines, centrally acting muscle relaxants and long-acting sleeping pills, the study said.
Physicians should pay special attention when writing prescriptions for elderly people and patients should minimize their reliance on medication, he said.
Elderly people are more sensitive to the effects of medication, Chen said.
They should try to avoid seeing a doctor or taking medication every time they experience discomfort and, instead, exercise and rest more, and maintain a balanced diet, he said.
The diagnosis and treatment of diseases in elderly people has become an important issue in aging societies and Taiwan has one of the fastest-aging populations, Chen said.
National Yang-Ming University hosted the Taiwan-Japan Conference for Geriatric Medicine yesterday.
It announced a five-year agreement with the University of Tokyo’s Graduate School of Medicine to facilitate cooperation between professors and students at the two universities, Chen said.
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