Clinicians may want to pay closer attention to patients who list an anticholinergic drug (ACD) on their medical history form, according to a new study out of France.1 While this class of medication—used to treat everything from depression and gastrointestinal disorders to Parkinson’s disease, urinary incontinence, epilepsy and allergies—has been linked to an increased risk of dementia, it now seems to increase a patient’s risk of developing late age-related macular degeneration (AMD) as well.1,2

Anticholinergics increase deposition of  amyloid-β in the brain; it turns out that’s also a major component of retinal drusen and primary AMD lesions, according to the study. As such, researchers questioned whether the drugs increase the risk of ocular disease. They looked at 200 patients with late AMD and 200 controls, of which 13% and 5%, respectively, were exposed to ACDs for at least three months before AMD onset. Data shows the risk of AMD increased with every exposure to ACDs, high Anticholinergic Burden Score (≥3) and longest cumulative exposure to ACDs.1

“A dose-effect association was suggested by a greater association with prolonged use and high Anticholinergic Burden Score,” the study concluded. “Further studies, in particular those with longitudinal design, are needed to confirm this association.”

1. Aldebert G, Faillie J, Hillaire-Buys D, et al. Association of anticholinergic drug use with risk for late age-related macular degeneration. JAMA Ophthalmol. May 24, 2018. [Epub ahead of print].
2. Richardson K, Fox C, Maidment I, et al. Anticholinergic drugs and risk of dementia: case-control study. Br J Ophthalmol. BMJ. April 25, 2018.