Common Medications Associated with Higher Risk of Dementia
Lindsay Knake
| 3 min read
Lindsay Knake is a brand journalist for Blue Cross B...
A group of common medications can increase the risk of dementia and falls, according to a growing body of research.
Anticholinergic medications are commonly used to treat allergies, diarrhea, incontinence, anxiety, depression and motion sickness, according to the National Library of Medicine. Up to half of older Americans take at least one these drugs, according to Indiana University.
But these medications can lead to serious side effects, including impaired cognitive function. Let’s look at the medications, what they do, the associated risks and safer alternatives.
What are anticholinergics?
Anticholinergic drugs block a chemical messenger called acetylcholine, which regulates heart rate, bodily secretions and muscle contractions; and plays a role in memory, concentration and attention. This type of medication inhibits certain functions of the parasympathetic or “rest and digest” nervous system.
There are several categories of anticholinergics, including:
- Sedating antihistamines such as hydroxyzine
- Skeletal muscle relaxants such as cyclobenzaprine
- Antidepressants including amitriptyline, doxepin, nortriptyline and paroxetine
- Antipsychotics such as olanzapine
- Overactive bladder medications including oxybutynin, solifenacin, tolterodine and trospium
- Antispasmodics including atropine, dicyclomine and scopolamine
- Antiemetics (anti-nausea medications) such as prochlorperazine and promethazine
Common side effects from these medications include:
- Dry mouth
- Dry eyes and blurred vision
- Increased heart rate
- Lack of urination
- Constipation
- Dizziness
- Drowsiness
- Confusion and disorientation
- Falls
- Delirium
Anticholinergics and dementia risk
A study published in 2024 of more than 284,000 British adults age 55 and older found a 49% increased risk of dementia in those who took anticholinergic medications for conditions such as depression, muscle pain and bladder control. Vascular dementia, which is caused by restricted blood flow to the brain, was the most common cause of dementia found in patients. While the findings are an association rather than a causation, the researchers found this indicates use of anticholinergic drugs contributes to approximately 10% of dementia diagnoses.
These medications have a cumulative effect, known as the anticholinergic burden. The risk of adverse effects increases with age and number of medications.
Older adults have increased blood-brain barrier permeability and lower acetylcholine transmission, which makes them more vulnerable to side effects of the drugs, according to the National Library of Medicine.
What to do if you take anticholinergics
If you are taking one or more anticholinergic medications, do not stop taking them cold turkey. Request a medication review with your primary care physician to discuss drug interactions, long-term risks and side effects. Safer medications for overactive bladder, muscle pain, anxiety and depression are available and may work for you. The American Academy of Family Physicians recommends doctors consider alternative medications or treatments before prescribing anticholinergics.
Seek immediate medical care if you have severe side effects from anticholinergic medications, including falls, confusion, a fast heart rate or delirium.
Image: Getty Images
Related:
You May Also Like
Why are Levels of Near-Sightedness Rising? What to Know About Myopia
Medically Reviewed by: Gretchen Goltz, D.O.
