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I’m sure many of us may have experienced adverse effects on our brain, as a result of taking certain types of medication. The most common ones include some of the older anti-histamines, which, while alleviating symptoms of allergy can make the person taking them really sleepy and tired because they cross the blood-brain barrier.

Having a groggy brain for a day or two is an inconvenience, but what if the medication resulted in long-term cognitive impairment? Results of a recent study have now shown that there is a group of medications called anti-cholinergics, which can cause long-term mild cognitive impairment associated with memory loss. Some of these drugs are readily available as over-the-counter preparations and others are prescription only.

This was an observational study carried out over a 6-year period on 1,600+ people. They were all over the age of 70, of African-American descent and had normal cognitive function at the beginning of the study. The researchers diligently recorded all of their over-the-counter medications, as well as all prescribed drugs, over that 6-year time frame.

The results showed that those subjects who took one anti-cholinergic medication had a significant increased risk of developing cognitive impairment. Taking two doubled that risk.

In an ageing population where the various risks for developing cognitive impairment abound, this finding is of great significance.

So what are anti-cholinergics? Well these are the medications whose effect is to block acetylcholine. They are commonly used to help with sleep problems, allergies, urinary incontinence and cough. And these just happen to be symptoms that are not uncommon in the older population. Brands and medicines include Benadyl® or Benylin®, Nytol® and Paxil®, Olanzepine, Paroxetine, Amitriptyline and Promethazine to name just a few.
They seem innocuous enough but the findings of this study should alert everyone to the need for vigilance in taking anything that could be potentially a cause of cognitive impairment. All older people would be well advised to check with their Doctor about medications they have been prescribed or have bought for themselves over-the-counter.

The findings from this study means that further research will now be undertaken to see whether the cognitive impairment produced by these drugs, is reversible and whether the effect is the same in different population groups. Both Dr Campbell and Dr Boustani who were involved in this study believe that these findings are likely to be generalised across all races.

A downloadable list of medications with definite and possible anticholinergic effects can be found at www.indydiscoverynetwork.com under the service/tools tab.

Which brings me onto eggs.

What is the connection between anticholinergics and eggs?

Well, eggs are a rich source of choline, along with sardines, liver, soya beans, lecithin and peanuts.

Choline is an essential nutrient we need to form acetylcholine. And the medications discussed in the study causing long-term cognitive impairment were the anticholinergics.

We need choline in our diet because our body cannot produce enough of what our brain and body requires. It is the egg yolk, which provides us with the richest source of choline, 200mg per yolk. Adult women need approximately 425mg choline per day. Men need 550mg.

Choline is essential for good brain health as it

• Forms acetylcholine, a vital neurotransmitter and key for encoding memory. (We need other vitamins as well to make acetylcholine, including B1, B5, B12 and C.) Acetylcholine is also essential for muscle control.
• As Citicholine, it helps to boost levels of dopamine and other brain neurotransmitters.
• Is an essential component of brain cell membranes vital for their integrity and plasticity. Much of the brain is made up of phosphatidycholine and sphingomyelin, which require choline for their synthesis.
• Is vital to healthy brain development in the unborn child and in early childhood, and to maintain good memory throughout life.
• A lack of choline can lead to deficiency of folic acid, a B vitamin that is also crucial for brain health.
• Choline and its derivative Betaine are associated with reducing homocysteine. Homocysteine is a normal by product of metabolism but in excess is linked to increasing inflammatory responses, which can cause heart disease and dementia.

There are lots of other good reasons to enjoy eggs, but for boosting choline levels and helping to maintain a healthy brain, enjoying six free-range eggs a week is a great start.

I think I will enjoy two poached eggs on toast for breakfast tomorrow

So how do you like your eggs?

1 Indiana University of Medicine (2010, July13th). Medications found to cause long-term cognitive impairment of ageing brain. “Neurology”
2 Duke University Medical Center (1998, April 9). Extra Choline During Pregnancy Enhances Memory In Offspring.
3 University Of North Carolina At Chapel Hill (2004, March 18). Scientists Discover Why Not Enough Choline Results In Fewer Brain Cells, Poorer Memory.

Dr Jenny Brockis

Dr Jenny Brockis is a medical practitioner and internationally board-certified lifestyle medicine physician, workplace health and wellbeing consultant, podcaster, keynote speaker and best-selling author. Her new book 'Thriving Mind: How to Cultivate a Good Life' (Wiley) is available online and at all good bookstores.

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