Dementia, a progressive disorder that impacts memory and independence, affects millions globally. While many are aware of lifestyle factors like smoking and alcohol consumption that can increase the risk of dementia, fewer realize that certain medications—both over-the-counter and prescription—may also play a role. Research has shown that up to 40% of dementia cases could be prevented through changes in lifestyle and healthcare choices. Below are five common medications linked to dementia risk, as highlighted by Dr. Zain Hasan, a Los Angeles-based anesthetist.
Antihistamines and Anticholinergics

Antihistamines, commonly used to treat allergies like hay fever, eczema, and conjunctivitis, are often taken without a second thought. These medications, particularly anticholinergics, are available over the counter and help manage symptoms like hives and itchy eyes. However, studies have found a troubling connection between their long-term use and dementia. For example, a 2015 study involving 3,400 older adults in the U.S. found that increased doses of anticholinergics correlated with a higher likelihood of developing dementia.
A 2024 study further examined this link using data from over 700,000 individuals with allergic rhinitis in Taiwan. Researchers discovered a dose-dependent increase in dementia risk among antihistamine users, suggesting that prolonged use of these medications could potentially harm brain health. Antihistamines and anticholinergics work by blocking certain neurotransmitters, which can interfere with brain signaling over time. Experts recommend using these medications only when necessary and exploring non-drug alternatives, such as saline nasal sprays or allergen avoidance strategies, to minimize potential long-term risks.
Opioids

Opioids, widely prescribed for managing severe pain following surgery, injuries, or cancer, have been linked to a range of neurological effects. Dr. Hasan emphasized that long-term opioid use can sedate the brain, and prolonged sedation may elevate dementia risk. A 2024 study analyzing data from over a million patients found that individuals with chronic pain who used opioids had a 15% higher risk of developing dementia compared to non-users. The study excluded factors like cancer diagnoses and family history of dementia, making the findings even more significant.
Patients relying on opioids should discuss alternative pain management strategies with their doctors to minimize potential cognitive risks. Chronic opioid use may also disrupt the brain’s reward system and impair cognitive function, further contributing to long-term mental decline. Exploring non-opioid pain relief methods, such as physical therapy, acupuncture, or non-addictive medications, can help reduce dependency and safeguard brain health.
Proton Pump Inhibitors (PPIs)

Proton pump inhibitors (PPIs), such as omeprazole, are commonly used to treat acid reflux and heartburn by reducing stomach acid production. While effective for gastrointestinal issues, these medications have been linked to dementia in recent research. A 2023 study published in Neurology tracked over 5,700 participants over 45 years and revealed that individuals taking PPIs for more than four years had a 33% higher risk of developing dementia. Scientists speculate that PPIs may increase beta-amyloid levels in the brain, a protein associated with Alzheimer’s disease.
Additionally, PPIs may reduce the absorption of vital nutrients like vitamin B12, which is essential for maintaining brain health. Long-term PPI use has also been associated with a reduction in magnesium and calcium absorption, potentially leading to deficiencies that impact overall health, including cognitive function. Researchers have suggested that shorter courses of PPIs or lifestyle changes, such as dietary adjustments and weight management, may be safer alternatives for managing acid reflux. It’s important for patients to regularly review their medication use with a healthcare provider to assess the necessity of continued PPI therapy and explore alternative treatments.
Benzodiazepines

Benzodiazepines, including medications like Valium and Xanax, are often prescribed to treat anxiety, insomnia, and seizures. These drugs work by calming the central nervous system, but their sedative effects may come at a cost. Dr. Hasan cautioned that long-term benzodiazepine use can numb brain activity and potentially lead to dementia. Research supports this claim; a study involving over 9,000 participants found that individuals taking benzodiazepines for more than six months had an 84% greater risk of developing Alzheimer’s disease compared to those who had never used these medications. If you rely on benzodiazepines, consult your healthcare provider about alternative treatments to reduce long-term risks. Gradual tapering under medical supervision, combined with therapy or non-sedative alternatives, can help manage anxiety and insomnia while minimizing the potential cognitive risks associated with benzodiazepines.
Tricyclic Antidepressants

Tricyclic antidepressants (TCAs) are an older class of drugs used to treat mental health conditions such as depression and anxiety. Though less commonly prescribed than newer antidepressants like SSRIs, TCAs still play a role in treatment for some patients.
According to Dr. Hasan, TCAs cross the blood-brain barrier and can impact brain function over time. Prolonged use of these medications has been linked to cognitive decline and an increased risk of dementia. Patients concerned about their mental health treatment should discuss safer alternatives with their doctors, ensuring their medication plan prioritizes both mental and brain health.
Talk to Your Doctor

Dr. Hasan advises patients taking any of these medications to consult with their healthcare providers before making changes. Abruptly stopping certain drugs, such as opioids and benzodiazepines, can lead to withdrawal symptoms and other complications. Additionally, those concerned about dementia risks should seek medical advice to explore safer options and preventive strategies.
Dementia remains a significant global health challenge, with millions of cases expected to rise in the coming decades. While medications can provide vital relief, understanding their potential risks is crucial for informed decision-making. Always prioritize open communication with your healthcare provider to safeguard your long-term health.
The Impact of Dementia on Global Health

Dementia is one of the leading causes of disability and dependency among older adults worldwide. It affects nearly 6.7 million Americans over the age of 65, with numbers projected to double by 2060. Globally, Alzheimer’s disease—the most common type of dementia—accounts for 50–75% of all dementia cases. The disorder not only disrupts memory but also impairs decision-making, behavior, and the ability to perform everyday tasks. With no definitive cure available, prevention is the most effective strategy. Understanding the role medications play in dementia development empowers individuals to make informed choices about their health and prioritize early interventions.
Medications and the Blood-Brain Barrier

A common thread among the medications linked to dementia risk is their ability to cross the blood-brain barrier, a protective shield that prevents harmful substances from reaching the brain. Drugs like benzodiazepines, tricyclic antidepressants, and anticholinergics interact directly with brain activity, often causing prolonged sedation or altering chemical pathways. Over time, these disruptions can lead to changes in brain structure and function, increasing the risk of cognitive decline. While these medications serve important medical purposes, their long-term effects on the brain highlight the importance of monitoring usage and exploring alternative treatments when appropriate.
Lifestyle Changes to Reduce Dementia Risk

In addition to carefully managing medications, adopting a healthy lifestyle can significantly reduce the risk of dementia. Regular physical activity, a balanced diet rich in nutrients like omega-3 fatty acids, and engaging in mentally stimulating activities can help protect brain health. Avoiding smoking, limiting alcohol consumption, and ensuring adequate sleep are also key factors. For those with existing medical conditions requiring medication, discussing the risks and benefits of treatment options with a doctor can help strike a balance between managing symptoms and minimizing long-term cognitive effects.
Nutritional Deficiencies and Brain Health

Several medications linked to dementia risk, such as PPIs, may interfere with the body’s ability to absorb essential nutrients. Vitamin B12 deficiency, for example, is a known contributor to cognitive decline and memory problems. PPIs and other drugs that reduce stomach acid can inhibit the absorption of this vital vitamin, potentially accelerating brain-related issues. Regular monitoring of vitamin levels and supplementation, when necessary, can help counteract these effects. For those on long-term medications, a diet rich in brain-boosting nutrients like folate, vitamin D, and antioxidants is a proactive step toward maintaining cognitive health.
The Importance of Medication Reviews

Regularly reviewing medications with a healthcare provider is an essential part of managing long-term health. As new research emerges, the understanding of how medications impact the brain continues to evolve. Annual or biannual medication reviews can help identify drugs with potential cognitive risks and allow for adjustments to treatment plans. For older adults in particular, a comprehensive evaluation of all prescriptions, including over-the-counter medications, can help minimize unnecessary risks. Open communication with doctors ensures patients are informed about the latest findings and empowered to make decisions that prioritize their overall well-being.
Safeguarding Your Brain Health

Understanding the potential risks associated with common medications is a critical step in safeguarding your brain health. While these drugs can provide essential relief for various conditions, their long-term impact on cognitive function shouldn’t be overlooked. By staying informed, maintaining open communication with your healthcare provider, and exploring safer alternatives when necessary, you can take proactive steps to reduce your risk of dementia. Coupled with healthy lifestyle choices and regular check-ups, these strategies can help protect your memory, independence, and overall quality of life as you age. Remember, knowledge is power, and taking control of your health today can lead to a brighter, healthier tomorrow.