The Older Brain on Drugs: Substances That May Cause Cognitive Impairment

Jenny Rogers, MD; Bonnie S. Wiese, MD; Kiran Rabheru, MD, CCFP, FRCP


Geriatrics and Aging. 2008;11(5):284-289. 

In This Article

Anticholinergics and Other Drugs to Avoid

A number of medications should generally be avoided by older adults as well as by individuals who have dementia, as they are thought to potentially worsen cognitive impairment ( Table 3 ).[1,40] These effects can be especially severe. Chronic use of anticholinergic medications may cause a cognitively intact individual to seem demented. In a geriatric community study (n=201), those who had serum anticholinergic activity greater than 2.8 pmol/ml were 13 times more likely to have a MMSE <24, which might be easily mistaken for a dementing process.[43] Anticholinergic effects are found in a wide range of both prescription and over-the-counter medications (see Figure 2). Some of the anticholinergic OTC medications (such as diphenhydramine [Benedryl®] and dimenhydrinate [Gravol®]) are commonly taken by older adults as sleep aids owing to their sedating effects.[46]

Figure 2.

Common Medical Drugs with Anticholinergic Effects


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