studies illustrate the concern:
- 2015 (JAMA Internal Medicine): In a U.S. cohort followed for ~7 years, people with the highest cumulative exposure to strong anticholinergics had a statistically significant increased risk of incident dementia, even when past use had stopped. Common culprits included older antidepressants (e.g., amitriptyline), bladder antispasmodics (e.g., oxybutynin), and first-generation antihistamines (e.g., diphenhydramine).
- 2019 (JAMA Internal Medicine): A large UK study found dose- and class-specific associations: higher cumulative anticholinergic exposure—particularly from antidepressants, bladder antimuscarinics, and anti-Parkinson’s drugs—was linked to increased dementia risk in
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