From: hound23x@gmail.com   
      
   Dementia findings are food for thought but not definitive proof   
   In light of possible link to some sleeping pills and antihistamines, it makes   
   sense for people to consider what they are taking   
   Tablets   
    Many older people are on multiple courses of drugs for a variety of   
   complaints. Photograph: Alamy   
   Sarah Boseley, health editor   
   Tuesday 27 January 2015 08.06 EST   
      
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   The possibility that some very common over-the-counter sleeping pills such as   
   Nytol and hayfever tablets like Piriton could trigger dementia is highly   
   alarming for those who take them and likely to lead to the binning of many   
   thousands of blister packs    
   on several continents.   
      
   But the research from Seattle does not actually prove the link, experts say.   
   It is a warning about the possible effects of long-term use of these drugs,   
   not a copper-bottomed forecast of how many people who have ever taken such   
   pills are going to get    
   Alzheimer's.   
      
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   The drugs under suspicion are anticholinergics, which include medicines   
   against allergies and some older anti-depressants, known as tricyclics, as   
   well as drugs to help with an over-active bladder.   
      
   This is not the first study to investigate whether there may be a link to   
   dementia. There is a plausible mechanism. The side-effects of these drugs   
   include memory loss, difficulty paying attention and slower thought processes.   
   But the assumption in the    
   past has been that those problems disappear again when people stop taking the   
   tablets. The Seattle study investigated whether there were long-term effects.   
      
   The best way to find out whether a drug does what you want it to - or what you   
   don't want it to - is through a randomised controlled trial, where large   
   numbers of people are recruited and split into two groups who either get the   
   drug or get something    
   else that has no effect. That's the gold standard but ethically it can't be   
   done when there are suspicions, as here, that some people might suffer harm.   
      
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   So the Seattle researchers did the best they could do instead. They recruited   
   a group of nearly 3,500 people over the age of 65 who did not have dementia   
   and tracked them over seven years. They had their complete computerised   
   pharmacy records, so they    
   knew what drugs they were on. And at the end of the study, the scientists were   
   able to say that more people on anticholinergic drugs got dementia than those   
   who were not on them.   
      
   These are not young people who pop into a pharmacy for a hayfever remedy or   
   the over-worked middle-aged who are looking for something to help them sleep.   
   These are people of 65 and over who are often on multiple pills every day for   
   a range of different    
   problems. They might be depressed and have an over-active bladder and an   
   allergy as well.   
      
   One of the strengths of the study is that it found a dose-response. The more   
   anticholinergic medicines somebody had been taking over the seven years, the   
   more likely they were to have dementia.   
      
   That is a real warning sign. Is it definitive? No, says Dr Simon Ridley, head   
   of research at Alzheimer's Research UK. "I'd still say not at this point,   
   because we'd want to see another study done, perhaps in a slightly different   
   way." The Seattle group    
   did their best to tease out other possible causes, but nobody can be certain   
   from an observational study like this whether those people taking   
   anticholinergic drugs may have been at greater risk of dementia for some other   
   reason.   
      
   But it makes sense for doctors and pharmacists to rethink what they give   
   people, and for the public to consider what they are taking where there are   
   alternatives. And there are alternatives for many of these drugs. Allergy   
   drugs have moved on and so have    
   antidepressants. It is the older drugs that are in question here. The modern   
   medicines are not anticholinergics.   
      
   Another question the study poses is about polypharmacy and how multiple drugs   
   interact. So many older people are on various courses of treatments for a   
   variety of complaints. All drugs have side-effects and some drugs interact   
   with others. Not much is    
   known about the extent of that, because each patient is on a different drug   
   cocktail. The Seattle researchers have given everybody food for thought on   
   that one, too.   
      
      
      
   http://www.theguardian.com/society/2015/jan/27/dementia-findings   
   sleeping-pills-antihistamines   
      
   --- SoupGate-Win32 v1.05   
    * Origin: you cannot sedate... all the things you hate (1:229/2)