Can Medication Cause Dementia-Like Symptoms?

Forgetting your next-door neighbor’s name. Missing lunch with friends because you mixed up the dates. Getting lost in a familiar place.If you’re an older adult and you start having problems like these, you may worry that they could be signs of mild cognitive impairment or dementia. But there’s another possible explanation: Certain medications can cause side effects which mimic cognitive concerns in older adults. There’s a chance that you could be experiencing problems that might improve if your provider prescribed a different medication.A qualified provider will be able to determine whether a cognitive condition or a medications side effect is the cause of your symptoms.

When medication causes side effects that are similar to symptoms associated with mild cognitive impairment or dementia, you may experience:

• Confusion 
• Forgetfulness 
• Memory problems 
• Trouble concentrating 
• Drowsiness 
• Mood changes 
• Personality changes 
• Agitation 
• Delirium 

Even seemingly minor side effects like drowsiness may cause problems in older adults. When medication makes you feel tired, it can prevent you from being as mentally sharp as usual. When you aren’t able to focus your attention, you may experience short-term memory loss or confusion.

Certain types of medication are more likely to cause memory problems and other dementia-like symptoms in older adults, including:

• Anti-anxiety medications 
• Antidepressants 
• Antihistamines 
• Muscle relaxants 
• Opioids 
• Pain medications given after surgery 
• Sleeping pills 
• Tranquilizers 

Only certain drugs in each category can cause cognitive side effects. And only certain people will experience these problems.Prescription drugs aren’t the only medications that have the potential to cause cognitive problems. Over-the-counter medicines can also cause memory lapses or other issues. Sleeping pills, in particular, can affect your cognitive state, especially as you age. Providers know this, so they might recommend lifestyle changes instead of medication to treat insomnia in older adults. If you take over-the-counter antihistamines or sleeping pills without visiting your provider, you might not find out about the risk of confusion or memory problems.

Older adults are more likely than younger adults to experience medication side effects like confusion or short-term memory loss. There are different reasons why this can happen.One factor: If you’re an older adult, you’re more likely to take medicine. As people age, they develop more chronic health conditions, which are often managed with medication. The more medicine you take, the greater chance there is for medication-related side effects.Another significant factor: When you age, your body doesn’t work as efficiently as it did before. This means that your kidneys and liver don’t function as well as they did in the past. The kidneys and liver play an essential role in helping you metabolize different types of medication, so that the medicine doesn’t build up in your body. If your kidney function slows with age, your kidneys won’t be able to eliminate medication from your system as quickly as it did when you were younger. It’s possible that too much medication in your system could cause issues with your memory.

If you notice that you’ve begun experiencing memory problems, confusion or other dementia-like symptoms soon after your provider has prescribed a new medication, bring it to their attention. They can determine if the drug is the cause of these unwanted changes.How can you tell that new cognitive problems might be medication-induced? They often arise suddenly, shortly after you begin a new medication regimen.You may notice, for example, that you’ve had difficulty concentrating since you started taking muscle relaxants for back pain, and you know that you didn’t have trouble with your attention span beforehand.By comparison, the memory problems and confusion that are associated with mild cognitive impairment and dementia tend to be more subtle changes that build slowly over time. You might not even recognize the changes, because they can be so gradual. (You might learn about the issue when family members voice their concerns.)

If you’re concerned about new symptoms like confusion or memory loss, make an appointment with your primary care provider. Mention any new medications that you’ve started taking.Your provider should ask about your medical history and perform a physical exam, a neurological exam and cognitive testing. If they find that medication – not a cognitive condition – is causing your symptoms, switching you to another medication should eliminate the problem. The amount of time that it takes for you to return to your baseline can vary, depending on the medication, your symptoms and other factors.

As you get older, you’re at greater risk of experiencing memory problems, but there are ways to reduce your risk of developing cognitive concerns as a medication side effect.If you’re an older adult and your provider prescribes new medication:

• Be curious. Never hesitate to ask your provider questions. Say things like: “What are the potential side effects of this medication?” Or: “Could this medication affect my memory, because of my age?” If your provider mentions that a drug could cause side effects that mimic cognitive problems, ask: “Is there another medication that might be better for me, to help me avoid confusion or issues with my memory?” 
• Weigh the benefits. Consider the possible risks of taking a new medication but also consider the advantages. If muscle relaxants will help you function independently without pain, you’ll probably want to take them, despite the possibility of cognitive symptoms. In some cases, you may be able to take medication sporadically, rather than daily, to minimize your risk of problems. 
• Monitor the situation. If you decide to take medication that could cause cognitive concerns, ask a family member to pay attention to your behavior. If they notice signs that you’re becoming forgetful, drowsy, or easily confused, they should recommend that you ask your provider to reassess your prescription. 

It's important to see your primary care provider on a regular basis to monitor your medications and related medical conditions for any changes to your health. If you don't have a primary care provider, we can help you find one. ChristianaCare's Swank Center for Memory Care offers comprehensive assessment, diagnosis, and treatment in a variety of locations.