In this issue of JAMA Internal Medicine, Coupland et al1 present a very important pharmacoepidemiologic nested case-control study using a database with high external validity and a methodological approach that maximizes internal validity. The study addresses a potentially modifiable risk factor for an important public health issue (the high prevalence of Alzheimer disease and related dementias [ADRD]). The authors1 report an association between long-term use of strong anticholinergic medications and the diagnosis of ADRD, replicating findings from similar studies from various international populations.2,3 Although we believe that articles such as Coupland et al1 add value to the body of literature describing the association between strong anticholinergic medications and ADRD, they provide only incremental new knowledge and require additional research to clarify whether anticholinergic medications truly represent a reversible risk factor for ADRD.
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Campbell NL, Holden R, Boustani MA. Preventing Alzheimer Disease by Deprescribing Anticholinergic Medications. JAMA Intern Med. Published online June 24, 2019. doi:10.1001/jamainternmed.2019.0676
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