List of Drugs Linked to Dementia

Dementia is a growing public health concern, affecting millions of people and their families. As of 2024, approximately 6.9 million Americans aged 65 and older are living with Alzheimer's dementia. This number is projected to nearly double by 2050. Globally, over 55 million people are currently living with dementia, with projections indicating a rise to 139 million by 2050. 

With dementia cases projected to increase in the coming decades, the need for awareness, early detection, and supportive care has never been greater. As the aging population grows, health care systems, caregivers, and communities must adapt to meet the rising demand for dementia-related services and interventions. 

 

The list of drugs linked to dementia includes anticholinergics, proton pump inhibitors (PPIs), pain medications, and benzodiazepines. These drugs can affect brain function by blocking neurotransmitters, altering brain chemistry, or interfering with nutrient absorption. 

• Anticholinergics reduce acetylcholine, a key neurotransmitter for memory and learning. 
• Prolonged PPI use has been associated with vitamin B12 deficiency and amyloid plaque buildup, both risk factors for dementia. 
• Painkillers may contribute to neuroinflammation and reduced oxygen flow to the brain, while benzodiazepines suppress brain activity, potentially leading to long-term cognitive decline. 

While these medications are often necessary for treating various conditions, health care providers recommend using them cautiously, especially if you’re an older adult, to minimize potential cognitive risks.

Anticholinergic medications are among the list of drugs linked to dementia. Anticholinergic medications are a class of drugs that block acetylcholine, a neurotransmitter responsible for transmitting signals in the nervous system. 

These medications can treat:

• allergies 
• overactive bladder
• depression 
• chronic obstructive pulmonary disease (COPD) 
• Parkinson’s disease. 

By inhibiting acetylcholine activity, these medications help relax muscles, reduce fluid secretions, and regulate involuntary bodily functions. 

However, blocking acetylcholine can also have unintended consequences, particularly in the brain. Acetylcholine plays a crucial role in learning, memory, and cognitive function; long-term use of anticholinergic medications has been linked to an increased risk of dementia and cognitive decline. 

Specifically, Benadryl and dementia have been linked through studies suggesting that prolonged exposure to strong anticholinergic drugs may contribute to structural brain changes and memory impairment. A 2019 study published in JAMA Internal Medicine found that higher cumulative use of certain anticholinergic medications was associated with a significantly increased risk of dementia.

Common anticholinergic medications

• Antihistamines: Diphenhydramine (Benadryl), Chlorpheniramine
• Bladder control medications: Oxybutynin (Ditropan), Tolterodine (Detrol)
• Antidepressants: Amitriptyline, Doxepin, Paroxetine
• Muscle relaxants: Cyclobenzaprine (Flexeril), Orphenadrine
• Parkinson’s Disease Medications: Benztropine (Cogentin), Trihexyphenidyl
• Gastrointestinal medications: Dicyclomine (Bentyl), Hyoscyamine

Another type of medication on the list of drugs linked to dementia are proton pump inhibitors (PPIs). PPIs are a class of medications designed to reduce stomach acid production. PPIs are commonly used to treat:

• acid reflux
• Gastroesophageal Reflux Disease (GERD)
• peptic ulcers
• other acid-related digestive conditions 

PPIs work by blocking the enzyme in the stomach lining that produces acid, helping to promote healing of ulcers and prevent damage to the esophagus. PPIs are often prescribed for long-term use in people with chronic acid reflux or severe digestive issues.

However, recent studies suggest that prolonged use of PPIs may be linked to an increased risk of dementia, particularly in older adults. Researchers are still studying the connection, but some believe that PPIs may contribute to cognitive decline by reducing the absorption of key nutrients like vitamin B12, which is essential for brain health. 

Additionally, PPIs may increase the buildup of beta-amyloid proteins in the brain, which are associated with Alzheimer’s disease. To minimize potential risk, health care providers often recommend using PPIs at the lowest effective dose and for the shortest necessary duration.

Common Proton Pump Inhibitors (PPIs)

• Omeprazole (Prilosec)
• Esomeprazole (Nexium)
• Lansoprazole (Prevacid)
• Pantoprazole (Protonix)
• Rabeprazole (AcipHex)
• Dexlansoprazole (Dexilant)

Pain medications are also on the list of drugs linked to dementia. Painkillers are designed to relieve acute and chronic pain caused by injuries, surgeries, medical conditions, or long-term diseases like arthritis and cancer. These medications work in different ways; some block pain signals in the nervous system, while others reduce inflammation or alter how the brain perceives pain. 

Some studies suggest that certain pain medications, particularly opioids and NSAIDs, may be linked to an increased risk of dementia. Opioids can impact cognitive function by altering neurotransmitter activity in the brain, leading to memory impairment over time. 

Long-term NSAID use has been associated with mixed results. While some studies suggest potential cognitive protection, others indicate a higher risk of dementia, possibly due to inflammation-related mechanisms. Health care providers often recommend cautious use of these medications, especially in older adults.

Common pain medications

• Opioids: Oxycodone (OxyContin), Hydrocodone (Vicodin), Morphine, Fentanyl
• NSAIDs: Ibuprofen (Advil, Motrin), Naproxen (Aleve), Celecoxib (Celebrex)
• Acetaminophen: Tylenol (Paracetamol)

Benzodiazepines are also on the list of drugs linked to dementia. This class of medication is primarily used to treat anxiety, insomnia, seizures, and muscle spasms. They work by enhancing the effects of gamma-aminobutyric acid (GABA), a neurotransmitter that slows down brain activity, resulting in a calming and sedative effect. Because of their ability to reduce anxiety and promote sleep, benzodiazepines are commonly prescribed for short-term relief of stress-related conditions.

However, long-term use of benzodiazepines has been linked to an increased risk of dementia and cognitive decline, especially in older adults. Studies suggest these drugs may contribute to memory impairment by affecting neurotransmitter balance and reducing brain plasticity. 

Studies have found that people using benzodiazepines for extended periods had a higher risk of developing Alzheimer’s disease, particularly when taken for more than six months. Because of these risks, many health care providers recommend using benzodiazepines at the lowest effective dose and for the shortest possible duration.

Common benzodiazepines

• For anxiety: Alprazolam (Xanax), Clonazepam (Klonopin), Diazepam (Valium), Lorazepam (Ativan)
• For insomnia: Temazepam (Restoril), Triazolam (Halcion)
• For seizures & muscle spasms: Clonazepam (Klonopin), Diazepam (Valium)

While we need further research to fully understand these connections, people of all ages can take proactive steps to manage their medication use and minimize potential risks. Being aware of what medications you’re taking and how they might affect brain health is an important part of dementia prevention.

For older adults, the risk is even greater. As we age, our bodies process medications differently, and the likelihood of taking multiple prescriptions — sometimes from different doctors — also increases. This combination can lead to dangerous drug interactions or cumulative effects that impair cognition. 

Seniors are especially vulnerable to medications that cause drowsiness, confusion, or memory problems, which can sometimes be mistaken for early dementia when, in reality, a medication adjustment could help. The good news is that there are ways to reduce these risks, and it starts with being proactive.

Being proactive includes having regular conversations with health care providers, bringing all medications (including over-the-counter drugs and supplements) to medical appointments, and asking about safer alternatives when possible. By taking a thoughtful approach to medication management, older adults may be able to reduce their dementia risk while ensuring they get the treatment they need.

With aging comes increased sensitivity to medications, driven by physiological changes such as slower metabolism, increased sensitivity to certain drugs, changes in body composition, and reduced kidney and liver function that impact drug distribution and elimination. 

These changes can make medications stay in the body longer, leading to stronger or prolonged effects. While not all drugs impact memory, many can cause side effects like dizziness, drowsiness, or confusion, increasing the risk of falls and impairing overall well-being. 

Additionally, senior adults are more likely to take multiple medications at once, raising the risk of drug interactions that can amplify confusion, drowsiness, or memory loss. Understanding these age-related changes is essential for safe and effective medication use.

As people age, their metabolism slows down, affecting how the body processes medications. The liver, which plays a key role in breaking down drugs, experiences a decline in blood flow and enzyme activity, leading to slower drug metabolism. This means that medications can stay in the bloodstream longer, increasing the risk of prolonged effects and potential toxicity, even at standard doses. 

The kidneys, responsible for filtering out waste and excess medication, become less efficient with age, further extending the time drugs remain active in the body. Because of this, older adults may require lower doses or adjusted medication schedules to prevent adverse effects.

For many older adults, their brains become more sensitive to central nervous system (CNS) drugs, including sedatives, painkillers, and medications for anxiety or depression. This heightened sensitivity is due to age-related changes in brain chemistry, receptor function, and a reduced ability to compensate for drug effects. 

As a result, older adults may experience stronger sedation, dizziness, confusion, or cognitive impairment from medications that affect the CNS, even at lower doses. This increased sensitivity can raise the risk of falls, delirium, and other complications, making careful medication selection and dosage adjustments essential for seniors.

Body composition shifts as we age, gradually decreasing muscle mass and increasing body fat. These changes can significantly impact how medications are distributed and stored in the body. Fat-soluble drugs, such as benzodiazepines and certain pain medications, may accumulate in fat tissue, leading to prolonged effects and a higher risk of sedation or cognitive impairment. 

Meanwhile, the reduction in muscle mass means less water in the body, which can lead to higher concentrations of water-soluble drugs in the bloodstream, increasing their potency and risk of side effects. These physiological shifts highlight the importance of medication adjustments in older adults to prevent unintended drug accumulation and adverse effects.

Aging generally leads to a decline in kidney function, which affects the body's ability to filter and eliminate medications. The kidneys gradually lose nephrons (the filtering units), and blood flow to the kidneys decreases, slowing down the clearance of many drugs, especially those primarily excreted through urine, such as certain antibiotics, blood pressure medications, and diabetes drugs. As a result, these medications can build up in the bloodstream, increasing the risk of toxicity and adverse effects, even when taken at standard doses. 

Because kidney decline isn’t always noticeable, regular monitoring through kidney function tests is crucial for older adults to ensure medications are properly dosed and adjusted as needed.

Liver function gradually declines with age due to reduced liver size, decreased blood flow, and slower enzyme activity. Since the liver is responsible for metabolizing many medications — such as blood thinners, statins, and certain pain relievers — this decline can cause drugs to break down more slowly, leading to prolonged effects and a higher risk of toxicity. 

Fat-soluble medications, in particular, may accumulate over time, increasing the likelihood of adverse effects. Because liver function decline often occurs without noticeable symptoms, regular liver function tests and careful medication management are essential for older adults to prevent complications.

Chemotherapy drugs, while essential for treating cancer, can have long-term effects on cognitive function, a phenomenon often referred to as "chemo brain." Older adults undergoing chemotherapy may be particularly vulnerable, as aging brains are already more sensitive to changes in blood flow, inflammation, and neurotoxicity. 

Some chemotherapy drugs can cross the blood-brain barrier, leading to cognitive impairment, memory problems, and an increased risk of dementia over time. While research is still ongoing, studies suggest that chemotherapy-induced cognitive decline may persist for months or even years after treatment, making it crucial for seniors to discuss potential risks with their health care providers.

Certain medications, including anticholinergics, PPIs, pain medications, and benzodiazepines, have been linked to an increased risk of dementia by affecting neurotransmitters, nutrient absorption, and brain chemistry. Medications like benzodiazepines may suppress brain activity, while some pain medications contribute to neuroinflammation. Older adults are especially vulnerable due to slower metabolism and decreased kidney and liver function, which can prolong drug effects and increase cognitive risks. To minimize risks, seniors should review medications with their doctors, explore alternatives, and use the lowest effective doses.

For those experiencing cognitive decline or needing additional support, senior care options such as independent living, assisted living, memory care, and nursing homes can provide varying levels of assistance. Independent living is ideal for active seniors seeking a maintenance-free lifestyle, while assisted living offers support with daily tasks. Memory care communities provide specialized care for individuals with dementia, and nursing homes offer 24/7 medical supervision for those with more complex health needs. Exploring these options can help seniors maintain safety, wellness, and a higher quality of life.

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