Letters Response

James Malone-Lee responds to the media flurry over safety of anticholinergic drugs in elderly people

BMJ 2011; 343 doi: http://dx.doi.org/10.1136/bmj.d4740 (Published 25 July 2011) Cite this as: BMJ 2011;343:d4740
  1. James Malone-Lee, professor of medicine1
  1. 1Research Department of Clinical Physiology, Division of Medicine, University College London Medical School, London N19 5LW, UK
  1. james.malone-lee{at}ucl.ac.uk

The intemperate hubbub over anticholinergic safety in elderly people, championed by the BBC on the morning of 24 June 2011, merits sober reflection.1 The focus was a paper by Fox and colleagues that was unavailable until 4 pm,2 when placed on the website of the Journal of the American Geriatrics Society. By then the media squall had dissipated. Recent UK history should deter such ill advised announcement of data through television, before it is published for peer scrutiny.

The article in question was a post hoc analysis of epidemiological data collected from older adults enrolled in the Medical Research Council Cognitive Function and Ageing Study. Participants were assessed using the mini-mental state examination (MMSE) in 1991 and 1993. The paper was published as an early online brief report, short on detail.

Anticholinergic exposure was measured crudely using a ranked …

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