Antidepressants, drugs for Parkinson’s disease, and urologic medications that have definite anticholinergic activity increase the risk of developing dementia up to 20 years after exposure, according to a large study from the United Kingdom. Many people use anticholinergic drugs at some point in their lives, and many are prescribed to manage chronic conditions leading to potentially long exposures…. Clinicians should continue to be vigilant with respect to the use of anticholinergic drugs, and should consider the risk of long term cognitive effects, as well as short term effects, associated with specific drug classes when performing their risk-benefit analysis.

It is well known that anticholinergic medications affect cognition. Guidelines indicate that they are to be avoided in frail, elderly patients. Prolonged exposure to anticholinergics has been linked to long-term cognitive decline and dementia. However, it has been unclear whether the increased risk is specific to the anticholinergic action itself or to the underlying conditions for which they were prescribed.