Medication and Mental Capacity

Medication and Mental Capacity

As estates practitioners know well, the medication that an individual takes could reflect underlying conditions that affect mental capacity.  High doses of pain medications or other medication prescribed to treat serious physical ailments may also impact a person’s cognition.

A recent article on Considerable highlights the impact that certain common medications may have on mental capacity.  An estimated 25% of seniors take “anticholinergic” drugs to treat a variety of common issues, including allergies, insomnia, and asthma.  These medications are known to target acetylcholine, a chemical messenger that plays an important role in concentration, cognition, and memory.  Some drugs (including over-the-counter medications as well as those for which a prescription is required) impact acetylcholine levels more than others and, when they are taken together, can have a cumulative effect.  As a result, high doses of anticholinergic drugs, which are often believed to have only inconsequential side effects, can interfere with brain messaging and result in symptoms consistent with dementia.

The article refers to a patient whose score on a Mini-Mental Status Examination increasing from 11 to 28 out of 30 after a readjustment of her medication, which included common antihistamines and medication for mood and gastrointestinal issues.  Further research is being conducted on the short-term and long-term effects of anticholinergic use, as there is concern that prolonged use may cause irreversible cognitive decline.

As our readers know, due to the nature of capacity standards and importance of reviewing capacity on a case-by-case basis at the time of the relevant decision or instructions, it may be worthwhile to consider whether medication, even that commonly prescribed to seniors, may be a contributing factor.

Thank you for reading.

Nick Esterbauer

 

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