Here’s an overview of recent research exploring links between medication use and dementia risk — and how some medicines might influence dementia risk, for better or worse.
🔎 Recent Findings: Medication and Dementia Risk
Gabapentin — increased dementia risk in some cases
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A 2025 study of adults with chronic low back pain found that those with six or more gabapentin prescriptions had a 29% higher risk of dementia and 85% higher risk of mild cognitive impairment (MCI) over 10 years compared with matched patients not receiving it. PubMed+2News-Medical+2
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The increased risk was especially notable in middle‑aged adults (35–64 years), where dementia risk more than doubled and MCI risk more than tripled for frequent users. PubMed+2Pharmacy Times+2
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Experts stressed this was an observational study — so it shows association, not proven causation — and called for caution and more research. sciencemediacentre.org+1
At the same time, not all studies agree — a large case‑control study from Taiwan found no significant association between gabapentin use and dementia risk. ScienceDirect
So while some data raise red flags about gabapentin, the evidence remains mixed.
Certain drugs with anticholinergic effects — possible higher dementia risk
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Several older studies have linked long‑term use of “strong anticholinergic” drugs — used for bladder control, depression, some Parkinson’s symptoms, etc. — with elevated dementia risk. PubMed+2BMJ+2
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For example, a 2024‑2025 analysis found that drugs used for overactive bladder (e.g., Oxybutynin, Solifenacin, Tolterodine) were associated with increased dementia odds, especially with higher cumulative exposure. PubMed+1
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However — and importantly — many of these findings are correlational. The underlying conditions (e.g., bladder issues, depression) themselves might contribute to risk. That makes it hard to disentangle whether the drug or the condition — or both — drive the observed association. BMJ+2European Pharmaceutical Review+2
Previous investigations also suggested that some older patients taking anticholinergics have short‑term memory problems; newer studies are exploring long-term effects. JAMA Network+1
Some medications may be protective — or reduce dementia risk
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A 2025 large-scale genetic study found that genetic traits associated with lower cholesterol were linked to much lower dementia risk — suggesting that medications that lower cholesterol might help reduce dementia risk in people with the right genetic profile. ScienceDaily
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Another 2025 epidemiological review suggested that anti‑inflammatory drugs (e.g., common nonsteroidal anti‑inflammatories) may correlate with modestly lower dementia risk — if used long-term. newsroom.wiley.com+1
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More broadly, a systematic review of hundreds of studies concluded that some medications — including antibiotics, antivirals, anti-inflammatories, and certain cardiovascular drugs — are associated with altered dementia risk (some increased, some decreased), and could be candidates for further research into dementia prevention or delay. PubMed+1
This suggests that drug‑repurposing (using existing medications for new uses) could be a viable path for dementia prevention — though the evidence remains preliminary. PubMed+2The Guardian+2
⚠️ Why It’s Hard to Draw Firm Conclusions
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Most data are observational. That means we see associations — not proof that the medication caused dementia. Factors like underlying illness, overall health, lifestyle, and other medications could confound results.
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Mixed and sometimes conflicting studies. As seen with gabapentin: some studies show increased risk, others show none. Similarly, short-term vs long-term exposure differences can reverse outcomes.
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Dementia is multifactorial. Age, genetics, vascular health, lifestyle, other chronic conditions all contribute. Medication may just be one small piece in a much bigger puzzle.
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Risk vs benefit tradeoffs. Some of these medications treat serious conditions (chronic pain, bladder issues, depression). For many people, the immediate benefit might outweigh a small long‑term risk — especially when evidence is not conclusive.
🧠 What Researchers Recommend (For Patients & Doctors)
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Use medications judiciously, especially when alternatives exist — particularly for drugs with anticholinergic activity.
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For long-term use (e.g., chronic pain requiring gabapentin), consider periodic cognitive monitoring. PubMed+2Medscape+2
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Further clinical trials and long-term studies are needed to clarify cause effects — not just associations.
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Consider overall dementia risk reduction strategies: good cardiovascular health, healthy lifestyle, controlling other risk factors — medication is only one piece.
If you like — I can pull up a full, up-to-date list (2020–2025) of all medication types that research currently links with increased OR decreased dementia risk (with approximate effect sizes, confidence levels, and number of studies).
