Concurrent Anticholinergic and Acetylcholinesterase Inhibitor Drug Use Among Older Adults with Dementia AARP Public Policy Institute
Concurrent Anticholinergic and Acetylcholinesterase Inhibitor Drug Use Among Older Adults with Dementia Commonly Done Never Advised
Getty Images Full Report
(PDF) Acetylcholine is the main neurotransmitter in the body. It functions to activate muscles and has an important role in attention, learning, memory and motivation. drugs block the transmission of acetylcholine in the central and peripheral nervous systems, while (AChEIs) increase its availability by blocking the enzyme (acetylcholinesterase) that breaks it down. The concurrent prescribing of anticholinergics and AChEIs is considered to be a “never event”—that is, a medical error that should never occur because the two drugs have opposing mechanisms of action. There is strong evidence of a link between anticholinergic drugs and impaired physical functioning, cognitive decline, and even death among older adults, and the American Geriatrics Society flags them for extra caution. Nonetheless, anticholinergic drugs are widely prescribed for older adults. Anticholinergic drug use is even more problematic among older adults with dementia who take acetylcholinesterase inhibitors (AChEIs) to slow the progression of their symptoms. This study was designed to determine if anticholinergic use among older adults with dementia taking AChEI puts them at higher risk for adverse outcomes and concludes that it does. Older adults with dementia who had concomitant anticholinergic and AChEI use were 18 percent more likely to experience a fall, 16 percent more likely to have a fracture, and 25 percent more likely to have a traumatic brain injury (TBI) than those taking AChEI alone. Nearly one-third (29 percent) of adults ages 65 years and older in the sample who were taking AChEI drugs for dementia were concurrently prescribed anticholinergic drugs for 30 or more days. Two-thirds of older adults take at least three prescription medications, often prescribed by more than one clinician. As this study highlights, an essential step towards high quality care should be for health care providers to regularly assess patients and their prescription drug regimens to ensure they remain appropriate (medication reconciliation). The full report includes a detailed methodological appendix. Suggested citation: Carter, Elizabeth, A., and Erwin J. Tan. Concurrent Anticholinergic and Acetylcholinesterase Inhibitor Drug Use Among Older Adults with Dementia Commonly Done Never Advised. Washington, DC: AARP Public Policy Institute, June 17, Search PPI
Find the Public Policy Institute content you are looking for by entering in search terms below. News Alerts Sign up for alerts on the latest research, events and videos on policy issues. Subscribe A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers Aging Demographics One in Three Americans is Now 50 or Older
By 2030, one out of every five people in the United State will be 65-plus. Will your community be ready? Cancel You are leaving AARP.org and going to the website of our trusted provider. The provider’s terms, conditions and policies apply. Please return to AARP.org to learn more about other benefits. Your email address is now confirmed. You'll start receiving the latest news, benefits, events, and programs related to AARP's mission to empower people to choose how they live as they age. You can also by updating your account at anytime. You will be asked to register or log in. Cancel Offer Details Disclosures
Close In the next 24 hours, you will receive an email to confirm your subscription to receive emails related to AARP volunteering. Once you confirm that subscription, you will regularly receive communications related to AARP volunteering. In the meantime, please feel free to search for ways to make a difference in your community at Javascript must be enabled to use this site. Please enable Javascript in your browser and try again.