The autonomic nervous system, consisting of the sympathetic and parasympathetic nervous systems, regulates essential functions such as blood pressure, digestion, and stress response. As people age, these systems become less efficient. This process can be exacerbated by certain medications, such as anticholinergics—often prescribed for bladder problems—which negatively affect the autonomic nervous system.
“Our study shows that older adults who take medication that impacts the autonomic nervous system are nearly three times more likely to become frail compared to their peers who do not take these medications,” says Dr. Aziz Debain. “We also find that many of these drugs are not specifically tested on people over 80, even though they are frequently prescribed to them.”
“Another important finding from our research is the link between autonomic nervous system dysfunction and nighttime blood pressure spikes. Older adults with reduced nervous system function are more likely to experience high blood pressure at night, leading to frequent nighttime urination and dizziness when standing up. This significantly increases the risk of falls and fractures,” Dr. Debain adds. “We are now investigating whether adjusting the timing and dosage of blood pressure medication could improve quality of life and reduce side effects in older adults.”
Dr. Debain advocates for a careful review and, where possible, a reduction of medication use in older adults to preserve optimal autonomic nervous system function. He also emphasizes the importance of physical therapy and a gradual approach to improving physical condition in frail older adults without endangering their health.