The relative importance of
antimuscarinic anticholinergic medications for
Parkinson's disease (PD) declined after the introduction of
levodopa, such that
anticholinergic medications are now much more likely to be prescribed for clinical indications other than
parkinsonism. Recent studies have found an association between
anticholinergic medication exposure and future risk of
dementia in older individuals and those with PD. These findings provide a further reason to avoid the use of
anticholinergic medications to treat motor symptoms of PD. More importantly, they raise the question of whether one of the goals of PD treatment should be to deprescribe all medications with
anticholinergic properties, regardless of their indication, to reduce
dementia risk. In this review, we discuss the use of
anticholinergic medications in PD, the evidence supporting the association between
anticholinergic medications and future
dementia risk, and the potential implications of these findings for clinical care in PD.