PPIs (omeprazole, esomeprazole, pantoprazole and similar) for heartburn and reflux were flagged by several observational studies as being associated with higher dementia risk, especially with long cumulative exposure.
However, more recent reviews and meta‑analyses conclude that the evidence is inconsistent and likely confounded (sicker people are more likely to be on PPIs), so a clear causal link has not been established. Current expert advice is not to panic, but to:
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Avoid unnecessary long‑term PPI use.
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Step down to the lowest effective dose and reassess the need periodically, especially in older adults.
5. Some anticonvulsants and mood stabilisers
Newer population studies suggest that chronic use of certain antiepileptic drugs may be associated with increased dementia incidence, though the data vary by medicine and underlying disease. Because uncontrolled seizures and mood disorders also harm the brain, any decision to change these drugs must be individualised and handled by a neurologist or psychiatrist.
How to lower your medication‑related dementia risk
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Do a full medication review. Ask your doctor or pharmacist to look at all prescriptions, over‑the‑counter drugs, and herbal products, focusing on anticholinergic load and sedative use.
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Prefer non‑drug strategies first for sleep, mild anxiety, bladder urgency, and reflux (sleep hygiene, CBT, pelvic‑floor therapy, diet changes) where appropriate, then add drugs only if needed.
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Use the lowest effective dose for the shortest time. This is central to deprescribing programs aimed at protecting brain health in older adults.
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Never stop brain‑active meds abruptly. Benzodiazepines, antidepressants, anticonvulsants, antipsychotics, and PPIs all require supervised tapers to avoid withdrawal or rebound problems.
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Monitor thinking and memory. New confusion, memory loss, or personality changes should trigger both a cognitive work‑up and a medication review.
If you’re worried about a specific drug you’re taking, the safest next step is to bring this question – and this list – to your prescribing clinician and ask, “Is there a safer option for me, or can we start reducing some of these?”
