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Anticholinergic drugs and risk of dementia: case-control study

BMJ 2018; 361 doi: (Published 25 April 2018) Cite this as: BMJ 2018;361:k1315

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Re: Anticholinergic drugs and risk of dementia: case-control study

Troubling implications to be sure, given that drugs such as SSRIs are some of the most widely used medications on the planet. However, another CNS-active chemical is conspicuous in its absence. Caffeine crosses the blood brain barrier readily and it affects the cholinergic system where it inhibits acetylcholinesterase, this amongst its many on-target and off-target mechanisms. I doubt the data source would support this kind of evaluation but do the authors even remotely think that there might be a small difference in the caffeine ingestion habits between the groups? It seems highly improbable as the sample size is just so large as to knock that lifestyle issue out of the realm of possibility, BUT we are talking about a very small increase in the odds ratios here.

Competing interests: No competing interests

26 January 2019
Michael A Vanzieleghem
Stella, Ontario, Canada