New research suggests no link between antibiotic use and a higher risk of dementia.
- Antibiotic
use is common in older people, with those over age 65 consuming 50% more
antibiotics than younger adults.
- Using
antibiotics is linked to disturbance of the gut microbiome, which may have
effects on cognitive function.
- However,
a new study may help reassure older adults who are concerned about taking
antibiotics, particularly for recurrent or long-term infections.
- The
study found that in healthy older adults, antibiotic use was not linked to
increased dementia risk.
As people age, they are
more susceptible to infections and, therefore, more likely to be prescribed
antibiotics. In fact, a report from the World Health Organization (WHO) noted
that people ages over 65 have the highest rate of antibiotic prescription,
being 50% more likely to consume antibiotics than younger
adults.
Although antibiotics are
vital for destroying the bacteria that cause infections, they also kill
beneficial bacteria, such as those that make up the gut microbiome, leading
to gut dysbiosis. Studies have
linked gut dysbiosis with cognitive impairment because of its effect on
the gut-brain axis.
However, findings from a
new study should help reassure those who need to take antibiotics. The study,
which followed healthy older adults for 5 years, found that antibiotic use was
not associated with an increased risk of cognitive impairment and dementia.
The study is published
in Neurology, the medical journal of the American Academy of
Neurology.
“While
the study is promising, its limitation lies in the relatively short follow-up
period. Future studies that examine the long-term effects of antibiotic use are
essential to provide a more comprehensive understanding. Additionally,
expanding research to include participants with pre-existing health conditions
may offer further insights into antibiotic use and cognitive health across
diverse populations.”— Steve Allder, MD, consultant neurologist at Re:Cognition Health,
who was not involved in the study, speaking to Medical News Today
Using
antibiotics 1 to 5+ times
The researchers used
Australian data from ASPREE (ASPirin
in Reducing Events in the Elderly), a randomized trial of community-based older
adults.
They identified 13,571
participants who did not develop dementia during the two years of follow-up and
for whom they had prescription records. They divided the participants into two
groups: those who had taken antibiotics at least once during the two years
(63%) and those who had not.
To determine whether
more antibiotics increased a person’s dementia risk, the researchers further
divided the groups based on how many times individuals had been prescribed
antibiotics during that period, from zero to more than 5.
They then followed them
up for five years. Allder explained that a longer follow-up time would have
given more weight to the findings:
“As the author acknowledges, a longer follow-up
period would provide more robust data to verify the findings. A follow-up
period of at least 10-15 years would be ideal to better evaluate long-term
associations between antibiotic use and cognitive decline, as dementia and
cognitive impairments often develop gradually over decades.”
Participants took
cognitive tests at the start of the study, after one year, and then every two
years until the end of the study. The tests measured cognition, memory,
thinking and language skills, and executive
function.
The researchers recorded
any diagnosis of dementia or cognitive impairment without dementia during the
follow-up period.
No association between antibiotic use
and dementia
During the 5-year follow-up, 461 people developed dementia, and 2,576
people developed cognitive impairment.
After adjusting for
sociodemographic and lifestyle factors, family history of dementia, baseline
cognitive function and medications that affect cognition, the researchers
analyzed whether there was any association between antibiotic use during the
first 2 years and subsequent cognitive decline or dementia.
People who had taken antibiotics, even frequently or
long term, showed no increased risk of developing dementia or cognitive
decline.
There was also no
association between specific antibiotic classes and dementia risk.
Allder told Medical News Today that
the findings should reassure older adults, adding:
“The study clearly shows
that antibiotic use does not increase the risk of cognitive impairment or
dementia for healthy older adults. The results are encouraging, particularly
given the prior concerns surrounding antibiotics and gut health. However, as
always, antibiotics should be used responsibly and as prescribed by healthcare
professionals.”
Take
antibiotics when prescribed to prevent confusion
Allder’s reassurance was
echoed by Clifford Segil, DO, neurologist at Providence Saint John’s
Health Center in Santa Monica, CA, who was also not involved in the study.
“Recurrent infections
requiring antibiotics indicate underlying illnesses, and infrequent antibiotic
use should not be a scary thing to do in old age or when young,” he said.
“Elderly patients with infections often become
confused and this transient confusion from an infection is called delirium.
Older people being treated with antibiotics should be reassured that using
antibiotics will treat delirium and have no effect on getting dementia,” Segil
told us.
How
to reduce your dementia risk
Both Allder and Segil
gave additional advice for reducing dementia risk.
“Maintaining
a healthy diet is crucial, with a focus on a Mediterranean
diet rich in fruits, vegetables, whole grains, fish, and
healthy fats. Regular physical activity, such as walking, swimming, or yoga,
helps support brain health. […] Additionally, prioritizing sleep and stress
management by practicing good sleep hygiene and using relaxation techniques can
benefit brain health.”
— Steve Allder, MD
“Engaging in mental
stimulation, like puzzles, reading, learning new skills, or participating in
hobbies, keeps the brain active. Staying socially connected is also important,
as social engagement through community activities promotes emotional and
cognitive well-being,” he added.
Segil also emphasized
the importance of mental stimulation, telling MNT:
“It is my opinion
structure is important and I advise my retired patients to take classes at
local universities. […] I think keeping your brain active, interacting with
people, and staying up to date [is] very important. I also emphasize leaving
your home is very healthy as it is important to get out, especially with all
the modern technology and comforts of home.”
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