Managing Chronic Pain, Part 2: Applying a Shift in Perspective

AUGUST 2, 2019     Dr. C

Second in a series. Read part one, dated July 26, 2019

Pain attacks me every day, and I set aside much of my time to manage it. Chronic pain management is now a significant part of my wellness map. Pain management techniques are rooted in the conceptualization of total pain as suffering plus pain, and that some of that suffering is connected to dysregulated emotions. I know that I can make positive changes that will reduce my daily pain levels.

Recently, pain has become a daily experience and has since become the focus of my wellness map tweaks. My tweaking is a more concentrated look at the “pause between.” This is a mental, and often physical, pause that I take before I continue to think or act to decrease the occurrence of dysregulated emotions and their consequences. Putting this into practice decreases my suffering, reduces my frustrations, and thus lowers my perception of pain.

Pain often triggers the “fight or flight” response, which then activates emotion. Emotions generated by pain are followed by thought and often action — a feedback loop designed to keep us safe from danger. But the loop can spin almost out of control. To prevent it from doing so, it is possible to insert a pause in the loop between pain and emotion, emotion and thought, and thought and action.

The pause between is first brought into focus through recognizing its potential and directing attention to that possibility. This represents a shift in perspective that says, “I can practice the pause between, and it will lower my pain.” It is an adjustment in how the mind is used during the day. Wherever I decide to take my mind each day is the easier path to walk on the following one. The brain likes familiar roads.

Sitting with the pause between takes daily practice. Maybe I should be grateful for my chronic pain, which reminds me of the importance of such a practice. On some days, my Parkinson’s disease-related chronic pain is draining — at all levels. No matter what I do, I can’t sit in the pause between. But I firmly believe in neural plasticity. If I keep my brain practicing pain management, then it will become easier.

The construction of a wellness map enhances its success. The CHRONDI elements can serve this function. Techniques that help to quiet the mind and slow it down allow more opportunities to sit in the pause between. A mentor, something I have been for many students, can also help you to experience the pause between and arrive at a better understanding of your resistance to sitting there.

The pause is a suspended moment emptied of normal emotion, thought, or action. Judgment is halted, and focus is aimed at sitting in the pause between. It is very brief at first, but with practice, the pause between can become longer in duration and more easily accessible.

It is like a fork in the road. Choose which fork to take, initially using thought and action, and eventually emotion. The pause between helps to change patterns of thought and action, decreasing the frequency of those that contribute to suffering. If you decide to select the other fork, the pause gives us the time to walk down that new path, implementing new patterns of thought and action, thereby helping to reduce suffering and lessen pain.

From the place of sitting in the pause between one can apply any of a wide range of techniques. Following are a few of my suggestions:

• Divert your attention to other tasks — for example, reading a book or playing a video game.
• Engage in physical exercise; take a walk or a bicycle ride.
• Get involved in a positive activity that brings meaning and purpose.
• Meditate.
• Talk to someone who can help.
• Use T.O.O.T.S. — “time out on the spot.”
• Calmly and rationally evaluate your choice of thoughts and/or actions, and choose wisely.

I use all of these techniques. They work better when I recognize and start first with the pause between and the goal of reducing personal suffering.

***

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

https://parkinsonsnewstoday.com/2019/08/02/managing-chronic-pain-part-2-applying-shift-perspective/

Four Research Centers Will Share $8 Million Parkinson’s Foundation Grant

AUGUST 2, 2019   BY MARY CHAPMAN IN NEWS.

The Parkinson’s Foundation has granted four U.S. institutions $8 million to design and launch Parkinson’s disease research studies over the next four years.

The newly designated Parkinson’s Foundation Research Centers will get $2 million each — $500,00o annually — to support their quests to drive innovative investigative developments, and advance studies toward a cure for Parkinson’s.

“We are proudly committed to funding promising Parkinson’s research to help drive change and better outcomes” for Parkinson’s patients, John L. Lehr, Parkinson’s Foundation CEO and president, said in a press release. “These recipients represent the very best and brightest, and we look forward to their major innovations in PD research and care.”

Under the expanded program, 66 applications were fielded from the U.S. and abroad, including those collaborating with other institutions. The four chosen were the Columbia University Irving Medical Center; the University of Florida, in collaboration with Emory University; the University of Michigan, in collaboration with the University of Texas Southwestern Medical Center;  and Yale School of Medicine.

The awards were based mostly on research novelty, the research’s ability to meet unmet needs, team synergy, and the investigation’s potential to make important discoveries.

“This support from the Parkinson’s Foundation will help us make a significant contribution to our understanding of Parkinson’s disease,” said Malu G. Tansey, PhD, director of the University of Florida’s Center for Translational Research in Neurodegenerative Disease. “We are thrilled they have chosen the University of Florida to help shape the future for people with Parkinson’s disease with new discoveries and better therapies.”

The new research centers each must take on at least three interconnected Parkinson’s investigations. Because innovations can occur during research, 10% of awards must be set aside for possible pilot projects or establishing new collaborations.

“We hope that fostering creativity and collaboration across multiple disciplines and looking at Parkinson’s from new angles will lead to important breakthroughs,” said James Beck, PhD, Parkinson’s Foundation senior vice president and chief scientific officer. “Not only research breakthroughs, but also finding new implications for precision care and ways to modify the disease itself.”

The award program is open to institutions globally that have, or can recruit, a team of scientists specializing in Parkinson’s. The team all may reside in the same geographical area and work at the same institution, or through a virtual center. Preference is given to applications that demonstrate cross-departmental or cross-instutional collaboration. The team will designate a center director — a recognized expert in Parkinson’s research — who will oversee all work. Research can be basic science or clinical research.The next application process is expected to open in the fall of 2021.

https://parkinsonsnewstoday.com/2019/08/02/parkinsons-foundation-grant-research-centers/

Simple Genetic System Controls Posture-Related Behavior, Insect Study Suggests.

  AUGUST 2, 2019     BY CATARINA SILVA IN NEWS

A small molecule that regulates the expression of genes, called microRNA, controls nerve cells involved in postural control by affecting a gene within motor neurons, according to a recent fruit fly study.

The research, “A Single MicroRNA-Hox Gene Module Controls Equivalent Movements in Biomechanically Distinct Forms of Drosophila” was published in Current Biology.

Parkinson’s disease is a multi-system neurodegenerative disorder with motor and nonmotor features. Among motor symptoms and signs are resting tremor, slowness of movement (bradykinesia), rigidity, impairment of posture, balance, and gait.

“Given that the circuit components of behavior are built under the influence of genes, the question arises as to what extent the genetic make-up of the organism affects the control of its movements,” the researchers wrote.

Scientists at the University of Sussex in Brighton, England, and the Champalimaud Centre for the Unknown in Lisbon, Portugal, looked at distinct developmental stages of the fruit fly — an animal model commonly used in the lab — and how they were affected by a genetic system composed of a microRNA, called miR-iab4 molecule, and a particular Hoxgene, called Ultrabithorax. This microRNA has been linked to motor control in fruit flies.

Of note, miRNAs are small, highly conserved non-coding RNA molecules involved in the regulation of gene expression (the process by which information in a gene is synthesized to create a working product, like a protein). Hox genes are a family of genes that act as major regulators of animal development.

By using fruit flies, scientists can isolate genes with associated roles in movement control, such as the Hox genes, which specify body segments during embryonic development — i.e., whether a segment of the embryo will form part of the head, thorax, or abdomen.

These genes have been thought to be involved only in the formation of body structures and the brain. But researchers now have found that microRNAs control the function, rather than the morphology, of motor neurons, and that post-developmental changes in the expression of Hox genes can modulate behavior in the adult fruit fly.

The team studied the animals’ self-righting behavior, an important motor milestone in invertebrate development. Self-righting refers to an innate response that allows a change in the posture (position) of an organism in respect to the ground. For instance, in fruit fly larva it enables the insect to rectify its orientation if turned upside down.

The miR-iab4 miRNA was found to be essential for normal self-righting behavior across fruit fly developmental stages — embryo, larva and adult —  which all are associated with different morphology, neural constitution, and biomechanics.

Researchers also found that this microRNA molecule inhibited the Ultrabithorax gene in a specific subset of adult motor neurons, and that such inhibition elicited the self-righting behavior, indicating changes in Hox gene function can modulate motor control in the adult insect.

How does this apply to humans? After birth, newborns reach several milestones, including motor ones, which doctors use to monitor infants’ development. One of those milestones is rolling over, an equivalent to the fruit fly’s self-righting behavior.

These fruit fly findings hold the potential to unravel the molecular basis of movement-related neurodegenerative disease, such as Parkinson’s.

“Although our work is focused on deducing fundamental biological principles — what you may call “basic science” — there are several possible biomedical projections of this study,” Claudio Alonso, PhD, said in a press release. Professor Alonso is Subject Chair for Neuroscience at the School of Life Sciences, a member of the research center of Sussex Neuroscience, and senior author of the study.

“For example, aging, as well as various forms of neural disease including motor neurone disease, Parkinson’s and Huntingdon’s disease, can degrade posture and motor control, leading to a deterioration of health and quality of life. In order to understand more about these conditions and to be able to map the anomalies caused by disease or advanced age, we need a deeper understanding of the genetic and physiological factors that underlie normal posture control and movement,” Alonso said.

According to Alonso, this is the first study to report Hox-dependent roles in neurophysiological and behavioral control in the fully formed organisms (once development has concluded).

https://parkinsonsnewstoday.com/2019/08/02/genetic-system-posture-related-behavior-study/

VR Game Allows Parkinson’s Patients to Move and Feel in Virtual Worlds

Dena Taha | August 1, 2019

USC engineers team with researchers and VR game designers to help Parkinson’s patients walk steadily with confidence

Day mode of Overcome (Photo/Naghmeh Zamani)

“Overcome.” 

This was the name chosen by a group of USC Viterbi School of Engineering students to embody their vision of developing a virtual reality game for over 10 million people worldwide living with Parkinson’s disease. Many of these patients’ mobility is impacted to the extent where even crossing the street can be challenging.

Symptoms such as stiffness, uncontrollable shaking, gait and balance problems are the first warning signs. According to the Parkinson’s Outcomes Project, the largest-ever clinical study of Parkinson’s done by the Parkinson’s Foundation, 71 percent of people living with Parkinson’s for at least 10 years, are susceptible to falls. The serious injuries caused by falls, particularly in older patients, can lead to disability, social isolation, and even nursing home placement.

How it works

Traditional physiotherapy is centered around strength training, stretching, and movement practice, usually in a clinic. However, studies have shown that activity performed in the context of the environment, like say, stepping over an obstacle, aids long-term retention in motor skills far more than simply being told to lift one’s foot. 

“Overcome” does exactly that.

THE VR GAME IS PLAYED WHILE WALKING ON A TREADMILL (PHOTO/NAGHMEH ZAMANI)

Patients roam a virtual modern city, complete with roads, pavements, buildings, and cars, and with an option of day/night mode, as they walk on a treadmill. “We wanted to keep the environment realistic in terms of design,” said Adim Abass, a USC Viterbi master’s student in the Department of Computer Science. They gain points by avoiding obstacles such as chairs, paper, plastic cups, etc. that are randomly generated on the sidewalk. However, a problem arises: the VR environment lacks the dimension of touch, which makes it not only unnatural, but also disconcerting when they walk into an object.

Viterbi students have made the VR experience more immersive by introducing a haptic feedback component in addition to audio feedback. When the patient comes into contact with an obstacle, a micro-controller alerts a vibration motor and they sense a vibration warning them to change their path. 

Naghmeh Zamani, a USC Viterbi Ph.D. student researching in the Haptics Robotics and Virtual Interaction Lab, deconstructs the need for haptics. “Haptics add the sense of touch to virtual environments. The appropriate force and vibration applied to the user’s hand or body help them experience touching a virtual object.”

Moreover, patients are asked to categorize certain objects with halos into, say, recyclables and non-recyclables. “Overcome” simultaneously flexes the patient’s cognitive abilities by adding this categorization task to enhance memory.

HAPTIC FEEDBACK THROUGH A MICROCONTROLLER (PHOTO/NAGHMEH ZAMANI)

VR vs reality

The biggest advantage of using virtual reality as opposed to walking in an actual park or on the streets is that it allows patients to get their recommended daily exercise in a more controlled and safe environment. 

Patients find it difficult to walk on uneven surfaces and usually walk at a slow pace. When lifting a coffee cup is a Herculean task, to venture outdoors and see people rushing by can be startling and discouraging, even. A game-like scenario in VR eliminates those problems and could make daily activity much more enjoyable and thus consistent, which is critical for recovery. “Our solution is not a substitute for being outdoors, but it eases the initial phase of rehabilitation,” Abass affirmed.

Engineering+

Living in an era of interdisciplinarity, which USC Viterbi Dean Yannis C. Yortsos coined as “the Engineering+ era,” allows USC Viterbi students to use their engineering, innovation, and design skills to address challenges in other fields. Presented with this project as part of the Augmented, Virtual and Mixed Reality course offered at USC Viterbi by the GamePipe Laboratory, Abass and Zamani immediately jumped on board, as did computer science master’s students Manjunath Shetkar, Menghan Li and Saumya Dureja.

THE TASK IS TO AVOID OBSTACLES AND CLASSIFY THEM (PHOTO/NAGHMEH ZAMANI)

Indeed, enhancing virtual reality is one of the 14 Grand Challenges for Engineering set forth by the National Academy of Engineering.

“In this class, I learned not only about developing VR games, but also about Parkinson’s disease and how people suffering from it cope every day,” Abass said. “This is another motivation. It’s why I chose to  study engineering.”

VR in healthcare

“Overcome” is part of a bigger project led by James Finley, an assistant professor of biokinesiology and biomedical engineering and director of the Locomotor Control Lab at the USC Division of Biokinesiology and Physical Therapy. 

Finley’s project, funded by the National Institutes of Health, aims to develop virtual reality as a technique to enhance physical training and improve engagement in the context of rehabilitation. It has two main aims: developing the VR application and understanding the science and skill-learning behind VR and usability testing.

Finley explains that using VR as a tool gives patients a graded exposure to obstacles, provides an engaging and fun approach to physical therapy, and tracks their progress.

Several hospitals already use VR rooms for Parkinson’s patients to undergo physiotherapy. However, “Overcome” could take it to the next level with its haptic feedback. The team hopes to deploy it on actual patients in the near future. 

“One of the great things about this project is being able to work with these student teams from different majors – computer science, biomedical engineering, biokinesiology and physical therapy and cinematic arts,” Finley said. “We each bring a unique expertise to the table and we learn from each other.”

https://viterbischool.usc.edu/news/2019/08/vr-game-allows-parkinsons-patients-to-move-and-feel-in-virtual-worlds/

Scientist receives major grant for diagnosis of Alzheimer's, Parkinson's via new skin test

2-Aug-2019  Case Western Reserve University School of Medicine

Significantly less invasive than current reliance on brain tissue

"In addition to early diagnosis, pinpointing the misfolded proteins in more accessible specimens such as the skin can be used for effectively monitoring disease severity and evaluating the therapeutic value of new treatments for Alzheimer's and other neurodegenerative diseases." -- Zou

Wenquan Zou, MD, PhD, an expert in prion and degenerative neurological diseases, has received a two-year grant for developing diagnostic tools for Alzheimer's disease, Parkinson's disease, and other related brain-based degenerative disorders via an innovative skin test that uses ultrasensitive technology. The new test is much less invasive than evaluating brain tissue, which is the only approach for making a definitive diagnosis today.

Alzheimer's is mainly associated with the accumulation of abnormal toxic amyloid β and tau proteins in the diseased brain. These "misfolded" proteins often hide in the brain and remain undetected as they destroy brain tissue--causing progressive memory loss, irreversible declines in thinking and speaking ability, severe mobility problems, and ultimately, death. Similarly, misfolded α-Syn proteins precipitate Parkinson's disease, whose symptoms include tremors, loss of automatic movements, difficulty walking, and speech changes.

Changes in the brain associated with Alzheimer's can begin more than 20 years before symptoms are detected, but the ultimate goal of Zou's test is to pinpoint the abnormal proteins in skin samples of patients before symptoms appear. While there are currently no treatments for slowing or stopping the damage caused by the disease-causing proteins, many researchers think that treatments in the future will deliver the best results when administered early in the disease process, before symptoms and brain damage are detected. Routine skin testing of those at risk may prove effective in this regard.

"In addition to early diagnosis, pinpointing the misfolded proteins in more accessible specimens such as the skin can be used for effectively monitoring disease severity and evaluating the therapeutic value of new treatments for Alzheimer's and other neurodegenerative diseases," said Zou, who is an associate professor in the departments of Pathology and Neurology, and associate director of the National Prion Disease Pathology Surveillance Center, at Case Western Reserve University School of Medicine.

The grant will be the first full application of the recently developed RT-QuIC (real-time quaking-induced conversion) technology to the readily accessible skin specimens in order to diagnose Alzheimer's. Previously he and his co-workers used the test to detect misfolded prion proteins in the skin of patients with Creutzfeldt-Jakob disease (CJD), which is sometimes described as the human version of mad cow disease. Prions are an abnormal form of a normally harmless protein found in the brain. 

They are responsible for an assortment of fatal neurodegenerative diseases called transmissible spongiform encephalopathies, including CJD in humans and mad cow disease and chronic wasting disease in animals. In that earlier work, RT-QuIC correctly detected abnormal prion proteins in the skin samples of each cadaver with CJD tested and in none of the non-CJD group, i.e., no "false positives."

Under the new grant, Zou will work to confirm preliminary findings that he and his co-worker Dr. Zerui Wang have already achieved in collaboration with Drs. Bin Xu of Virginia Tech University and Thomas Beach of the Arizona Alzheimer's Consortium. These initial, small-sample-size data revealed that the RT-QuIC test is able to detect misfolded tau proteins in autopsied skin and brain tissue samples of patients with Alzheimer's disease. 

The new test may offer several advantages over existing methods for diagnosing Alzheimer's. For example, while brain imaging and cerebrospinal fluid analysis can detect some of the misfolded proteins, the two techniques are often ineffective in the early stages of the disease, expensive, and in the case of cerebrospinal fluid analysis, invasive. Moreover, while certain existing lab tests and immunofluorescence microscopy can detect misfolded tau and α-Syn proteins in the skin tissue of Alzheimer's and Parkinson's patients, these approaches have highly variable levels of sensitivity to the presence of the toxic proteins, making them generally unreliable and inconsistent as diagnostic tools.

In the new RT-QuIC test, researchers mix a small amount of skin sample with normal tau protein. The misfolded protein has the ability to convert the normal protein into the misfolded form by constantly shaking the mixtures. Once the normal protein is converted into the misfolded form, the particles bind together to form a larger aggregate that triggers a fluorescence probe to release fluorescence light monitored in a real-time scale by a researcher. In this way, the small amount of misfolded tau protein can be significantly amplified by integrating with the normal protein, and thus can be readily detected.

"Since skin biopsy is substantially less invasive than spinal tap and brain biopsy, and because RT-QuIC is highly sensitive and specific and therefore more accurate than other lab-based methods, it is conceivable that the test represents a promising tool for diagnosing, characterizing, and predicting Alzheimer's disease as well as Parkinson's and other neurodegenerative diseases," said Zou.

###

Funding for the project is provided by the Alzheimer's Association, Alzheimer's Research UK, the Michael J. Fox Foundation for Parkinson's Research, and the Weston Brain Institute. The grant award is for $149,729.00 over the course of two years (Grant ID: 18012).

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

https://www.eurekalert.org/pub_releases/2019-08/cwru-srm080219.php

How singing is helping those who suffer from Parkinson’s disease

August 2, 2019   By By Robbie Sequeira, Staff Writer

Despite being diagnosed with Parkinson’s Disease, Paul Ennis’ love for music and singing hasn’t dimmed.

Through music therapy classes on every Wednesday afternoon at First Baptist Church of Ames, he gets to sing a favorite song of his.

It’s a Perry Como classic: “Catch a Falling Star,” a song that reminds him to hold onto precious things life has to offer.

“We all have our struggles. We all are having a hard time,” Ennis said. “But the song, to me, means catch a happy feeling or moment and keep it in your pocket. It helps during the rough days.”

Ennis, along with 20 others in the class, who are also affected by Parkinson’s, will be performing in the third-annual Parkinson’s Disease Singing Festival at 6:30 p.m. on Saturday, Aug. 10, at First Baptist Church of Ames.

Elizabeth Stegemöller, assistant professor of kinesiology at Iowa State University and the festival’s organizer, leads the Ames group, but she also has conducted studies on how singing and vocal exercises can improve functions for those with Parkinson’s.

“We do a lot of vocal exercises in classes that focus on those muscles,” Stegemöller said. “We also talk about proper breath support, posture and how we use the muscles involved with the vocal cords, which requires them to intricately coordinate good, strong muscle activity.”

Parkinson’s Disease is an incurable and neurodegenerative disorder that, as the disease progresses, includes a host of deteriorating motor functions for those diagnosed.

“We often associate Parkinson’s Disease with tremors, or shaking, but there is also a gradual and progressive toll being taken on those who suffer from it,” Stegemöller said.

Age is often a factor in susceptibility to the disease, according to the National Institute of Health. An estimated 10 million people are living with Parkinson’s worldwide, and the average age of onset is 60 years old.

Some of the findings from Stegemöller’s study have already been published in Medical and Rehabilitation Journals for Parkinson’s Disease.

However, through music as means of therapy, Stegemöller has seen a link between singing and improvement in motor functions for Parkinson’s patients.

In 2017, she headed research at ISU, and data from that study found that singing can improve patients’ breathing, allowing them strength in their muscles to speak and swallow

Singing requires the use of the same muscles associated with swallowing and respiratory control, two functions complicated by Parkinson’s that can lead to death.

Motivated by her research, Stegemöller has been holding music therapy classes in Ames, Waverly and Des Moines over the past three years, with the goal to improve patients’ muscle activity and coordination through song.

“Music has a therapeutic link for many people — they way we hear certain notes, the way we connect with sound,” Stegemoeller said. “For the people I’ve been working with, seeing the improvement over each week with their breathing is always encouraging. It’s what make all of this so rewarding.”On Aug. 10, Parkinson’s Disease singing groups from across the country will come together united by an afflicting and degenerative disease, but a motivation to not let Parkinson’s define them.

Ennis, himself, will continue to participate in the classes, because they have become in a sense — a falling star.

On Aug. 10, Parkinson’s Disease singing groups from across the country will come together united by an afflicting and degenerative disease, but a motivation to not let Parkinson’s define them.Ennis, himself, will continue to participate in the classes, because they have become in a sense — a falling star.

“Every day can be different with (Parkinson’s) but things like this, and being in a group with others who are going through similar struggles — makes you appreciate moments like this,” he said.

https://www.amestrib.com/news/20190802/how-singing-is-helping-those-who-suffer-from-parkinson8217s-disease

Drugs for Parkinson’s, Depression Can Raise Dementia Risk By 50%

Written by Julia Rieson     August 2, 2019

Study looked at older adults’ dementia risk after taking anticholinergic drugs.

Anticholinergic drugs may be more harmful than beneficial — especially when it comes to brain health. Getty Images

Researchers have shed light on yet another risk factor that could potentially up your chances of developing dementia down the road: anticholinergic drugs. 

About 5 million peopleTrusted Source in the United States are currently living with dementia, a number that’s expected to skyrocket within the next 30 yearsTrusted Source. 

Though the condition affects millions of people around the world, what causes and prevents dementia and we know a handful of risk factors —like high cholesterol, diabetes, and drug use — that contribute to the onset of dementia

But many cases of dementia do not have a clear cause. 

Now this new research sheds light on other potential causes of the condition. 

Researchers found that anticholinergic drugs, which are frequently prescribed by doctors for a variety of illnesses, may spike older adults’ risk of getting dementia by about 50 percent.

Anticholinergics boosted people’s dementia risk

The research adds to a number of previous studiesTrusted Source suggesting that anticholinergic drugs may be more harmful than beneficial — especially when it comes to brain health. 

The studyTrusted Source was recently published in JAMA Internal Medicine. 

Anticholinergics are used to treat a wide range of conditions — from depression and Parkinson’s disease to bladder disorders, gastrointestinal issues, and insomnia. 

“The takeaway is that when people are offered or are on a medication for long-term use, it is a good idea to ask the prescribing physician about anticholinergic properties and whether there are alternatives,” Dr. Frank Longo, a neurologist and the chair of the department of neurology and neurological sciences at Stanford Health Care, told Healthline.

In this study the researchers evaluated the health data of 284,343 people ages 55 and older sourced from the UK QResearch primary care database.

Of the 284,343 people, the team identified 58,769 patients who’d been diagnosed with dementia.

The team then looked at what type of anticholinergic medication, if any, the people had been taking. 

Approximately 57 percent of the people with dementia had been prescribed at least one anticholinergic drug within 11 years of being diagnosed with the condition. Nearly 51 percent of people without dementia had also been prescribed at least one anticholinergic drug in the same time frame. 

The researchers found that those who took anticholinergics had about a 50 percent higher chance of having dementia.

Additionally, those who took antidepressants, antipsychotic drugs, anti-Parkinson’s drugs, overactive bladder drugs, and anti-epileptic drugs had the greatest risk of developing dementia. 

What to know about taking these drugs

The medications work by blocking acetylcholine, a chemical that helps relax and contract your muscles.

When this chemical is blocked, people’s memory and attention can become impaired — which is the reason so many people complain of acute confusion and memory loss while taking these medications. 

It’s thought that over time anticholinergics can inhibit these cognitive functions and eventually make certain people more vulnerable to the type of degeneration that occurs in dementia.

“Long-term blockage of the transmitter may lead to an acceleration of memory loss or even potentially degeneration of these types of cells in the brain,” Dr. David Merrill, a neurologist and geriatric psychiatrist at Providence Saint John’s Health Center in Santa Monica, told Healthline.

Still, more research is needed to better understand exactly why anticholinergic drugs may increase people’s risk of dementia. 

While there may be other factors at play, the researchers suspect that anticholinergics may cause about 10 percent of all new dementia cases. 

If you’re on any anticholinergics drugs, you may want to check in with your doctors about these risks, health experts warn.

Should you stop taking your medications?

According to the researchers, people should definitely weigh their drug’s benefits alongside the risks to determine if alternative treatments are available. 

Ask your doctor whether the drugs you’re taking have strong anticholinergic properties. If they do, it may be worth looking into other medication options. 

“Fortunately, for most of these drugs there are alternative or newer drugs in the same category of the original drug that have little or no anticholinergic effects,” Longo said.

That said, you shouldn’t stop taking your medications abruptly without first talking to your doctor about your options, he added.

How to curb your risk of dementia

Earlier this year, the World Health Organization (WHO) released new guidelines on how to lower your chances of getting dementia. 

The key, it seems, is to follow a healthy lifestyle. 

Eat a well-balanced diet by loading up on fruit, veggies, fish, and whole grains.

Regular exercise can also keep your brain sharp and cut your chances of experiencing cognitive decline. Most experts recommend getting about 150 minutes of moderate physical activity a week. 

Alcohol and cigarette use has also been linked to dementia, so if you want to keep your brain healthy, you’ll want to cut back on those. 

That said, moderate consumption of alcohol — think a couple glasses of wine a week — may actually reduce your risk of dementia. 

If vitamins and supplements have made their way into your diet to boost your brain health, the WHO suggests dropping them. There really isn’t enough research out regarding whether or not supplements can prevent dementia, so it’s better to hold off until we have the science to back them up. 

Lastly, stay social. When we age, we tend to isolate ourselves and let our friendships fall to the wayside. Interestingly, isolation and loneliness are associated with cognitive decline. Not to mention, friendships can help boost your mood and promote overall better health. 

“‘Use it or lose it’ is a true refrain for muscle strength and bone density,” Merrill said. “We now know the same is also for brain health.”

The bottom line

New research found that anticholinergic drugs — including certain antidepressants, Parkinson’s medications, and bladder drugs — may spike older adults’ risk of getting dementia by about 50 percent. The research supports previous evidence suggesting that medications with anticholinergic properties may do more damage than good. 

Given the findings, health experts don’t recommend stopping your medications abruptly, but it may be worth asking your doctor about alternative treatment options. 

https://www.healthline.com/health-news/common-drugs-may-cause-1-in-10-dementia-cases-what-to-know#What-to-know-about-taking-these-drugs