Intended for healthcare professionals

Letters Anticholinergic drugs and risk of dementia

Drugs for dementia: exercise is medicine

BMJ 2019; 364 doi: (Published 10 January 2019) Cite this as: BMJ 2019;364:k5438
  1. Damian M Bailey, professor of physiology and biochemistry and Royal Society Wolfson research fellow,
  2. Thomas A Calverley, PhD student,
  3. Robin Corkill, consultant neurologist
  1. Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Mid-Glamorgan, UK
  2. Department of Neurology, University Hospital of Wales, Heath Park, Cardiff, UK
  1. damian.bailey{at}

Richardson and colleagues found an association between anticholinergic drugs and risk of dementia.1 We appreciate their epidemiological approach but would like to direct some attention towards the mechanistic adaptations that may underlie this association.

The authors correctly allude to neurodegeneration as the pathological process precipitating dementia. But we should also focus on cerebrovascular changes given recent evidence indicating that …

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