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Never stop a prescribed drug abruptly on your own – especially benzodiazepines, anticonvulsants, antidepressants, or PPIs – as this can be dangerous. Always discuss changes with your prescriber.
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Ask about your anticholinergic burden. Pharmacists and doctors can review all of your prescriptions, OTC meds, and even sleep aids to estimate anticholinergic load and suggest safer alternatives.
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Use the lowest effective dose for the shortest necessary time. This principle is central to deprescribing programs designed to reduce dementia risk.
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Prioritise non‑drug approaches for sleep, bladder urgency, heartburn, and mild anxiety when appropriate (sleep hygiene, pelvic‑floor training, diet changes, CBT), then add medication only if needed.
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Monitor cognition over time. If you or family notice new memory loss, confusion, or personality changes, seek evaluation; clinicians may adjust medications as part of the work‑up.
Bottom line
The strongest and most consistent dementia‑risk signal comes from long‑term, high‑burden use of strong anticholinergic medications, particularly in older adults. Sedatives like benzodiazepines, some anticonvulsants, and possibly prolonged PPI use may also contribute, especially when layered together with other brain‑active drugs.
For most people, these medicines are safest when:
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Used for a clear, compelling indication.
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Reviewed regularly.
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Tapered or switched to safer alternatives once the benefit is no longer clear.
If you are concerned about your own medicines, the most useful next step is a structured medication review with your doctor or pharmacist, focused on reducing anticholinergic and sedative load while still treating your underlying conditions effectively.
