Medication Exposure and Risk of Dementia and Alzheimer's Disease

Abstract

Alzheimer's disease (AD), a complex neurodegenerative disease (ND), is the most predominant cause of dementia among the elderly. Generally, elderly people have multiple chronic health conditions, like hypertension, arthritis, diabetes, insomnia, bowel problems, and depression. Although prescribed medications have beneficial therapeutic compositions, some may have side effects that could hinder cognitive function or worsen cognitive decline. Hence, we should evaluate those medications to guarantee their safety. In the present mechanistic review, we discussed frequently used categories of medication (analgesics, anticholinergics, benzodiazepines, proton pump inhibitors, and statins), concerning their possible involvement in increasing AD and dementia risks. This review summarized the results of various observational studies, meta-analyses, randomized case-control studies, and systematic reviews. As the results were contradictory, it was difficult to ascertain the clear associations between medication usage and increased risks of dementia or AD. The blood-based biomarkers (BBMs) offer a low-cost and accessible alternative for early diagnosis of AD. Systematic reviews combined with meta-analysis would be crucial tools for accurately assessing and summarizing the efficacy of health interventions, yet randomized clinical trials have always been the best way to help with clinical care decisions. Thus, an open discussion is necessary to help individuals determine whether the advantages of utilizing medications outweigh the possible drawbacks.

Keywords: alzheimer’s disease; analgesics; anticholinergics; benzodiazepines; dementia risk; proton pump inhibitors; statins.

Figure 1

Broad classification and structures of some analgesics.

Figure 2

Increased risk of AD/dementia associated with the use of analgesics. Frequent use of opioids (>20 prescriptions) was associated with the highest risk of AD/dementia in comparison to NSAIDs. The graph was plotted using data reported by Gao et al., 2024 [43].

Figure 3

Evaluating cognitive impacts of opioids vs. NSAIDs.

Figure 4

Some common examples and applications of anticholinergic drugs.

Figure 5

Association between anticholinergic use and AD/dementia risk. In this category, antipsychotics pose a higher risk of AD/dementia in comparison to others. The graph was plotted using data reported by Coupland et al., 2024 [70].

Figure 6

Common effects, uses, and examples of benzodiazepines.

Figure 7

Summary and structures of some common proton pump inhibitors.

Figure 8

Proton pump inhibitor pathways linked to AD risk.

Figure 9

Structures of some statins.

Figure 10

Statin use reduces dementia and AD risk. The graph was plotted using data reported by Ren et al., 2024 [156].