Category: Dementia

Five drug groups carry warnings for older adults, yet prescribing remains highest among those with dementia.

One in four older Americans with dementia is prescribed potentially inappropriate medicines that affect the brain and nervous system.

These drugs can increase the risk of confusion, falls and hospitalisation, particularly in people whose thinking and memory are already impaired.

Despite decades of warnings, people with cognitive impairment were more likely to receive these prescriptions than those with normal cognition.

Five drug groups

The research examined five categories of medication flagged by prescribing guidelines for older adults:

• Antidepressants with strong anticholinergic effects.
• Antipsychotics.
• Barbiturates.
• Benzodiazepines.
• Nonbenzodiazepine sleeping medicines, sometimes called Z-drugs.

Only antidepressants with strong anticholinergic properties were included in this category.

Anticholinergic medicines block acetylcholine, a chemical messenger involved in memory, learning and concentration.

Blocking its action can cause confusion and other unwanted effects, especially in older adults.

Benzodiazepines, which may be prescribed for anxiety or sleep problems, can cause excessive drowsiness and increase the risk of falls.

Some medicines also take longer to leave the body as people age, allowing their effects to persist or accumulate.

Who receives them?

The researchers analysed survey information linked to medical insurance records from almost 4,900 Americans aged 65 and over.

They examined prescribing over nine years, counting prescriptions for at least four weeks’ supply.

Around 17 percent of people with normal cognition received at least one potentially inappropriate prescription, compared with almost 22 percent of those with cognitive impairment without dementia.

Among people with dementia, the proportion reached 25 percent.

Some encouraging changes

Across the older adults studied, prescribing fell from around 20 percent at the beginning of the study period to 16 percent at the end.

Much of the decline reflected fewer prescriptions for benzodiazepines and Z-drug sleeping medicines.

However, prescribing rates for the other three drug groups did not change significantly.

By the final year, more than two-thirds of people receiving these potentially inappropriate prescriptions lacked a documented clinical reason for at least one of them.

When benefits outweigh risks

A potentially inappropriate medicine can still be justified when its expected benefits outweigh its risks.

The practical question is whether each prescription remains suitable for the person taking it.

Dr Annie Yang, the study’s first author, emphasised the importance of patients and carers reviewing these medicines with their physicians:

“While CNS-active prescriptions may be appropriate in some cases, it is important for older patients or their caregivers to work closely with their physicians to ensure that these medications are appropriate to their cases.

When inappropriate, patients and their care teams should consider alternative treatments and consider whether it might be safe to taper or stop the medication.”

The study was published in JAMA (Yang et al., 2026).

Your brain uses this nutrient for memory, but its relationship with dementia risk is more complicated than “more is better”.

Moderate intake of choline, a nutrient found in eggs, fish and legumes, is linked to a lower risk of dementia.

Older adults consuming moderately high amounts had a 32 percent lower dementia risk than those consuming the least.

However, the highest intake was not associated with a clear benefit, suggesting that more is not necessarily better.

Tracking dementia risk

The research followed over 5,000 American adults, whose average age was almost 69, for around eight years.

Participants were initially free of dementia but around 500 developed the condition during follow-up.

After dividing participants into five groups according to choline intake, the researchers found a 32 percent lower dementia risk in the second-highest group than in the lowest, after accounting for other factors.

However, there was no statistically clear reduction in the highest-intake group.

The result therefore points towards a potentially beneficial range, rather than a steady fall in risk with every increase in consumption.

The researchers then combined their results with four previous studies to assess the broader pattern.

Together, these followed almost 138,000 people and recorded around 2,500 cases of dementia.

In the combined analysis, dementia risk fell as choline intake rose to approximately 465 milligrams per day, with no further reduction beyond that level.

Choline and memory

Choline helps the brain produce acetylcholine, a chemical messenger involved in learning and memory.

It also supplies building blocks for the membranes surrounding brain cells, helping maintain their structure and communication.

These roles could help explain a link between choline and cognitive ageing, although they do not prove that consuming more prevents dementia.

The nutrient also participates in processes that regulate homocysteine, a substance linked to problems with blood vessels and cognitive function.

Food sources matter

Eggs, meat, poultry and nuts were among the main sources of choline in the American participants’ diets.

People consuming more choline obtained a greater proportion of it from eggs.

Crucially, the analysis assessed choline from food and did not include intake from supplements.

The findings therefore cannot establish whether choline supplements would lower dementia risk.

Related

• 8 Everyday Eating Habits That Reduce Dementia Risk (P)

The study was published in the Nutrition Journal (Chen et al., 2026).

Prescription drugs taken by millions of people around the world can affect memory.

Memory loss is not always a result of ageing.

Here are five types of drugs that can affect memory.

1. Antidepressants (tricyclic)

The older type of antidepressants — known as tricyclics — have been linked to memory loss.

Some of the drug names include:

• desipramine (Norpramin),
• imipramine (Tofranil),
• clomipramine (Anafranil),
• and doxepin (Sinequan).

Around half of people taking them report problems concentrating and one-third say they have memory loss.

2. Anxiety drugs

Benzodiazepines include drugs marketed under the names Valium, Ativan, Klonopin and Xanax.

These drugs are often prescribed for anxiety and other mental health issues such as OCD, insomnia and post-traumatic stress disorder.

Unfortunately they are also linked to memory loss and even Alzheimer’s.

Dr Helene Alphonso, a psychiatrist and Director of Osteopathic Medical Education at Texas University, said:

“Current research is extremely clear and physicians need to partner with their patients to move them into therapies, like [modern] anti-depressants, that are proven to be safer and more effective.”

3. Statins

Statins are prescribed to many people to keep their cholesterol in a safer range.

The Food and Drug Administration lists memory loss, forgetfulness and confusion as possible side-effects of the drug.

Some people do report memory problems when taking them, but the studies conducted so far are inconclusive.

Statins include:

• Atorvastatin (Lipitor),
• lovastatin (Mevacor),
• fluvastatin (Lescol),
• and pravastatin (Pravachol).

4. Beta-blockers

Beta-blockers slow the heart rate and are used to lower blood pressure.

They are also prescribed to those with congestive heart problems.

Typical names include:

• Carvedilol (Coreg),
• atenolol (Tenormin),
• metoprolol (Lopressor, Toprol),
• and propranolol (Inderal),

Beta-blockers, though, may also cause the loss of emotional memories.

They have even been tested as a way of treating post-traumatic stress disorder because of their ability to block emotional memories.

Again, though, the studies are not conclusive.

4. Sleeping aids

People who cannot sleep are sometimes prescribed so-called ‘Z-drugs’.

These include:

• Zolpidem (Ambien),
• eszopiclone (Lunesta),
• and zaleplon (Sonata).

The ‘Z-drugs’ have been linked to memory loss: especially losing the ability to make new memories.

They have also been reported to cause strange behaviours like driving or cooking with absolutely no memory of the event.

What are the alternatives?

Where possible consider a psychological therapy or applicable alternative to using these drugs.

Naturally, you should always consult your physician before making changes to your medication.

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A study finds a link between levels of one vitamin in the brain and how well people maintain their cognitive abilities.

Higher levels of vitamin D in the brain are associated with better cognitive performance and a slower decline in thinking abilities as people age.

Research has repeatedly linked sufficient vitamin D levels with a lower risk of dementia (1, 2, 3).

One study has estimated that maintaining adequate vitamin D could potentially prevent nearly one in five cases of dementia (Navale et al., 2022).

The evidence, however, is not consistent, as other research has found no association (also: Owusu et al., 2018).

The latest study approached the question differently by examining vitamin D directly in the brain, an area that has received relatively little research.

Professor Sarah Booth, one of the study’s authors, said the findings highlight the need to understand how nutrients and diet may help the ageing brain withstand diseases such as Alzheimer’s and other forms of dementia.

Vitamin D markers

The researchers followed 290 older adults and examined their brain tissue after death to determine how much vitamin D was present.

Dr Kyla Shea, the study’s first author, explained that previous research has generally relied on people’s diets or measurements of vitamin D in their blood when investigating its relationship with cognitive function.

The researchers therefore wanted to establish whether vitamin D is actually found in the human brain and, if so, whether brain concentrations are related to changes in cognition over time.

The results showed that participants with greater concentrations of vitamin D in their brains tended to have better cognitive function.

There was no corresponding association between brain vitamin D levels and the physical changes in the brain typically associated with Alzheimer’s disease.

As a result, the researchers cannot yet say exactly why vitamin D might be associated with better cognitive health.

Dr Shea noted that dementia involves multiple biological processes, many of which are still poorly understood. Vitamin D may therefore be connected with other aspects of brain health that were not examined in this study and could be investigated in future research.

How much vitamin D?

The findings do not mean that people should start taking large doses of vitamin D to protect against dementia.

Current recommendations are 600 IU of vitamin D per day for adults under 70 and 800 IU for those aged over 70.

Dr Shea said the study establishes that vitamin D is present in the brain at meaningful levels and that greater amounts are associated with less cognitive decline.

However, she stressed that more research is needed to determine which changes in the brain are associated with vitamin D before treatments or other interventions can be developed.

The study was published in the journal Alzheimer’s & Dementia (Shea et al., 2022).