This One Mistake Could Make Dementia Worse
You fill up the pill organizer... set the reminders... and pick up the refills... all to make sure your loved one takes every dose.
But some of those pills could be adding to the very problems you're trying to manage.
November is near, and it also happens to be National Family Caregivers Month. If you're caring for a spouse... a parent... or other loved one with dementia, I want you to bring up one question at their next doctor's visit:
Are all of these medications still helping?
There's good reason to ask this...
Medications for sleep, anxiety, or bladder issues can often leave folks with dementia more confused, less steady on their feet, or too drowsy to make it through their day.
In a JAMA study published earlier this year, researchers reviewed records for 4,842 Medicare patients aged 65 and older from 2013 through 2021. The team tracked certain medications that affect the brain and nervous system, counting prescriptions with at least a 28-day supply.
These are drugs that can worsen confusion, cause heavy drowsiness, and raise the risk of falls. And for folks who already struggle with daily tasks, those kinds of side effects can threaten their independence.
The study found that 1 in 4 dementia patients were prescribed a potentially risky medication that affects the brain and nervous system.
These drugs, also called potentially inappropriate medications ("PIMs"), are linked to a higher hospitalization rate... A study published in the Journal of the American Geriatrics Society in August looked at 2,796 older adults with dementia or other cognitive problems. As it turns out, receiving PIMs was associated with a 38% higher rate of hospital stays.
If you care for someone with dementia, you need to know what they're taking... and why.
Now I want to be clear... Some of these drugs still serve important purposes. But your loved one's prescription regimen still deserves a closer look from time to time.
Now let's look at the five types of medications worth reviewing with a doctor or pharmacist...
Ask Your Doctor About These Five Medications
1. Anticholinergics
It's a long, alphabet soup of a name. But you probably have some of these pills in your medicine cabinet...
Think Benadryl (or diphenhydramine), the overactive-bladder drug oxybutynin, and tricyclic antidepressants like amitriptyline.
Anticholinergic drugs block acetylcholine, an important chemical that helps brain cells communicate to carry out tasks from muscle movement to memory support. In turn, that can worsen confusion.
Plus, with cold and flu season starting up, you'll definitely want to read the active ingredients listed on those "all in one" over-the-counter remedies... That's because some products marked "PM" contain diphenhydramine or doxylamine to help with insomnia.
2. Prescription sleep aids
Ambien (zolpidem), Lunesta (eszopiclone), and Sonata (zaleplon) fall under a group of drugs nicknamed "Z-drugs."
These sedatives prescribed for insomnia work with a brain chemical called GABA that slows down brain activity. But in dementia patients, taking Z-drugs can lead to increased confusion, worsened memory, and more daytime drowsiness.
3. Certain anxiety drugs
Xanax (alprazolam), Ativan (lorazepam), and Valium (diazepam) belong to a group of drugs called benzodiazepines.
While these meds can help calm the nerves, older adults are especially sensitive to their effects, which include memory problems, increased agitation, confusion, dizziness, and falls.
4. Antipsychotics
Seroquel (quetiapine), Risperdal (risperidone), and Haldol (haloperidol) are examples of antipsychotics, which are prescribed to treat mental health conditions like bipolar disorder, schizophrenia, and depression.
These drugs are sometimes prescribed to treat aggression or severe agitation in dementia patients. However, the Food and Drug Administration ("FDA") has given these drugs its strongest safety-warning level for older adults with dementia-related psychosis (or who have hallucinations or delusions). The FDA warns that these drugs carry a higher risk of death and stroke for these folks.
5. Opioid painkillers
Strong painkillers like OxyContin (oxycodone), Vicodin (hydrocodone), and morphine can provide much-needed relief from severe pain. But these drugs can also cause drowsiness, confusion, and even delirium (i.e., sudden, severe confusion) – all of which can be especially dangerous for someone struggling with dementia.
Plus, mixing opioids with sedatives like Xanax or Ativan can dangerously slow down breathing and even lead to an overdose.
This doesn't mean that someone with dementia has to completely stop painkillers and suffer through severe pain. Rather, it's worth asking their doctor whether the dosage is still appropriate or if an alternative treatment might work just as well.
What You Can Do
Make it your mission to round up every prescription, over-the-counter remedy, and supplement for a pharmacist or doctor to review. This is also called a "brown bag" review, where you chuck all of your meds into a bag and have them evaluated for recalls and interactions.
For each drug, you should ask questions like these...
- What is it treating?
- Is it still helping?
- Is there a safer choice?
You should also watch out for a "prescribing cascade." That's when a side effect from a drug gets mistaken for a new illness... which then gets treated with a new drug.
For example, donepezil, commonly prescribed for Alzheimer's disease, can sometimes worsen bladder leaks. A doctor might then tack on oxybutynin, a drug for overactive bladder, which can work against the dementia drug's effects in the brain.
At home, be sure to keep a record of any new or worsening symptoms like confusion, falls, unusual sleepiness, or behavioral changes.
And finally, don't stop or change any medications without talking to their doctor first.
Some drugs (sedatives, especially) must be tapered slowly to avoid dangerous withdrawal symptoms.
You've already put so much care into making sure your loved one takes every medication on time... It's time to raid that medicine cabinet to make sure every prescription belongs there.
Dementia takes an enormous toll on patients and caregivers. In my new book, Power Up Your Brain!, I've uncovered the hidden costs of this condition – and how you can keep it from ruining your mental, physical, and financial health. Plus, I've revealed 23 research-backed strategies for keeping your brain healthy as you age.
So whether you're hoping to prevent cognitive decline, are watching a loved one suffer from it, or are already experiencing it yourself, you need this book in your arsenal. Click here to get your copy today.
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Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
October 27, 2026