Obat-obatan Umum Ini dapat Meningkatkan Risiko Demensia

Beberapa obat umum dapat meningkatkan risiko demensia. Penelitian baru oleh para ilmuwan dari Universitas Nottingham di Inggris telah menganalisis hubungan antara kelas obat tertentu dan risiko demensia. Obat-obatan tersebut, yang disebut antikolinergik, bekerja dengan menghambat kurir kimia yang disebut asetilkolin. Efeknya adalah membantu merilekskan atau berkontraksi otot, dan dokter dapat meresepkannya untuk membantu mengobati kondisi kandung kemih, masalah pencernaan, dan beberapa gejala penyakit Parkinson.
Dalam studi baru mereka, yang melihat data dari puluhan ribu peserta, para peneliti menyimpulkan bahwa antikolinergik dapat meningkatkan risiko seseorang terkena demensia. Institut Nasional untuk Penelitian Kesehatan mendanai penelitian ini, dan para ilmuwan mempublikasikan temuan mereka kemarin di JAMA Internal MedicineTrusted Source.
Peningkatan risiko hampir 50%
Untuk penelitian mereka, ketua peneliti Prof. Carol Coupland dan tim menganalisis catatan medis dari 58.769 orang dengan demensia dan 225.574 orang tanpa demensia. Mereka semua berusia 55 tahun atau lebih pada garis dasar. Di antara mereka yang menderita demensia, 63% adalah wanita dan usia rata-rata adalah 82 tahun. Untuk setiap orang dengan demensia, para peneliti menemukan lima pertandingan kontrol pada usia dan jenis kelamin yang sama dan yang menghadiri praktik umum yang sama untuk menerima perawatan medis.
Coupland dan rekannya mengambil data dari database QResearch dan melihat rekam medis dari antara 1 Januari 2004 dan 31 Januari 2016. Para peneliti menemukan bahwa obat antikolinergik secara umum dikaitkan dengan risiko demensia yang lebih tinggi. Lebih khusus, bagaimanapun, antidepresan antikolinergik, obat antipsikotik, obat anti-Parkinson, obat kandung kemih, dan obat epilepsi dikaitkan dengan peningkatan risiko tertinggi.
Di antara ini, obat yang paling sering diresepkan adalah antidepresan, obat anti-vertigo, dan obat kandung kemih kandung kemih (untuk pengobatan kandung kemih yang terlalu aktif). Hasil ini tetap bahkan setelah para peneliti mengendalikan variabel pengganggu (atau faktor risiko yang diketahui untuk demensia), termasuk indeks massa tubuh (BMI), status merokok, penggunaan alkohol, masalah kardiovaskular, dan penggunaan obat lain, seperti obat antihipertensi.
Secara keseluruhan, para peneliti menyimpulkan bahwa orang berusia 55 atau lebih yang menggunakan antikolinergik yang kuat setiap hari selama setidaknya 3 tahun memiliki kemungkinan hampir 50% lebih tinggi untuk mengembangkan demensia daripada orang yang tidak menggunakan obat jenis ini. “Penelitian ini memberikan bukti lebih lanjut bahwa dokter harus berhati-hati ketika meresepkan obat-obatan tertentu yang memiliki sifat antikolinergik,” jelas rekan penulis penelitian, Prof. Tom Dening.
“Namun,” dia memperingatkan, “penting bahwa [orang] yang minum obat semacam ini tidak hanya menghentikan mereka secara tiba-tiba, karena ini mungkin jauh lebih berbahaya. Jika [orang] memiliki masalah, maka mereka harus mendiskusikannya dengan dokter mereka untuk mempertimbangkan pro dan kontra dari perawatan yang mereka terima. “
‘Risiko harus dipertimbangkan dengan cermat’
Untuk menilai kekuatan obat antikolinergik dan seberapa sering peserta meminumnya, tim melihat informasi yang tersedia tentang resep selama 10 tahun. Namun, mereka mencatat bahwa ini adalah penelitian observasional, sehingga mereka tidak dapat mengkonfirmasi apakah obat tersebut secara langsung bertanggung jawab atas peningkatan risiko demensia.
Para peneliti menambahkan bahwa dokter mungkin telah meresepkan beberapa obat ini kepada pasien mereka tepatnya untuk pengobatan gejala demensia yang sangat dini. Namun demikian, Prof. Coupland berpendapat bahwa “penelitian ini menambah bukti lebih lanjut tentang risiko potensial yang terkait dengan obat antikolinergik yang kuat, terutama antidepresan, obat antimuscarinic kandung kemih, obat anti-Parkinson, dan obat epilepsi.”
“Risiko dari jenis obat ini harus dipertimbangkan dengan hati-hati oleh para profesional kesehatan di samping manfaat ketika obat yang diresepkan dan perawatan alternatif harus dipertimbangkan jika memungkinkan.” Prof. Carol Coupland “Temuan ini juga menyoroti pentingnya melakukan tinjauan obat secara teratur.”
“Kami menemukan risiko yang lebih besar untuk orang yang didiagnosis dengan demensia sebelum usia 80, yang menunjukkan bahwa obat antikolinergik harus diresepkan dengan hati-hati pada orang paruh baya maupun pada orang tua,” ia menyimpulkan.

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