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Commonlyprescribed drugs are tied to nearly 50% higher dementia risk in older adults,study says

研究表明,在老年人中,普通处方药与将近50%的高痴呆风险有关



(CNN)Scientists have long found a possible linkbetween anticholinergicdrugs and anincreased risk of dementia.

长期以来,科学家们发现抗胆碱能药物与痴呆症风险增加之间可能存在联系。

A study published in the journal JAMAInternal Medicine on Monday suggests that the link is strongest for certainclasses of anticholinergic drugs -- particularly antidepressants, bladderantimuscarinics, antipsychotics and antiepileptic drugs.

周一发表在《美国医学会内科杂志》上的一项研究表明,某些类型的抗胆碱能药物——尤其是抗抑郁药、抗膀胱蛔虫药、抗精神病药和抗癫痫药——与这种联系最为紧密。



She said that people taking thesemedications are advised not to stop them without consulting with their doctorfirst, as that could be harmful.

她说,建议服用这些药物的人在没有咨询医生之前不要停止服用,因为这样做可能是有害的。

The study involved analyzing data on284,343 adults in the United Kingdom, aged 55 and older, between 2004 and 2016.The data came from QResearch, a large database of anonymized health records.

该研究分析了2004年至2016年间英国年龄在55岁及以上的284343名成年人的数据。这些数据来自QResearch,一个包含匿名健康记录的大型数据库。



The researchers found that the odds ofdementia increased from 1.06 among those with the lowest anticholinergicexposure to 1.49 among those with the highest exposure, compared with having noprescriptions for anticholinergic drugs.

研究人员发现,与没有服用抗胆碱能药物的人相比,服用抗胆碱能药物最少的人患痴呆症的几率从1.06增加到服用抗胆碱能药物最多的人的1.49。

The study had some limitations, includingthat some patients may not have taken their prescribed medication as directed,so anticholinergic exposure levels could have been misclassified. Theresearchers found only an association between anticholinergic drugs anddementia risk, not a causal relationship.

这项研究有一些局限性,包括一些病人可能没有按照医嘱服药,因此抗胆碱能暴露水平可能被错误分类。研究人员只发现抗胆碱能药物与痴呆症风险之间存在关联,而不是因果关系。

"However, if this association iscausal, the population-attributable fractions indicate that around 10% ofdementia diagnoses are attributable to anticholinergic drug exposure, whichwould equate, for example, to around 20,000 of the 209,600 new cases ofdementia per year in the United Kingdom," the researchers wrote in the study.

研究人员在研究报告中写道:“然而,如果这种联系是偶然的,人口可归因比例表明,约10%的痴呆症诊断可归因于接触抗胆碱能药物,例如,这相当于英国每年209,600例新增痴呆症病例中的约20,000例。”

Since the study shows only an association,more research is needed to "clarify whether anticholinergic medicationstruly represent a reversible risk factor" for dementia, wrote experts NollCampbell, Richard Holden and Dr. Malaz Boustani in an editorial that publishedalongside the new study in JAMA Internal Medicine.

由于该研究只显示了一种相关性,因此需要更多的研究来“阐明抗胆碱能药物是否真的代表了痴呆的可逆风险因素”,诺尔·坎贝尔、理查德·霍尔登和马拉兹·布斯塔尼博士在一篇社论中写道。

"Additionally, deprescribing trialscan uate potential harms of stopping anticholinergic medications, such asworsening symptoms of depression, incontinence, or pain, as well as the potentialunintended increase in acute health care utilization," Campbell, Holdenand Boustani wrote in the editorial.

“此外,去处方试验可以评估停用抗胆碱能药物的潜在危害,如抑郁症、尿失禁或疼痛症状恶化,以及急性医疗保健使用率可能意外增加,”坎贝尔、霍尔登和布斯塔尼在社论中写道。

"With little evidence of causation,the next steps for research on anticholinergic medications in older adults mustimprove knowledge of the effect of deprescribing interventions on cognitiveoutcomes and important safety outcomes such as symptom control, quality oflife, and health care utilization," they wrote. "We proposedeprescribing research as a high priority."

他们写道:“在缺乏因果关系证据的情况下,研究老年人抗胆碱能药物的下一步必须提高对去处方干预对认知结果和重要安全结果(如症状控制、生活质量和卫生保健利用)的影响的认识。”“我们建议将禁用研究列为优先事项。”



"Some of the medications that theylist in the study may be quite critical and important and are well worth theperson taking for their seizures or their psychosis, and so it's a risk-benefitdiscussion," he added. "So have a conversation with yourdoctor."

他补充说:“他们在研究中列出的一些药物可能非常关键和重要,对于癫痫或精神病患者来说非常值得服用,因此这是一个风险-收益的讨论。”“那就和你的医生谈谈吧。”