People With Dementia Should Avoid Certain Drugs

By Jeanine Kendle
The elderly with dementia generally tolerate drugs more poorly than healthy older individuals. Increased sensitivity to certain side effects, difficulty following drug regimens and decreased ability to recognize and report adverse events are common reasons.
The elderly with dementia also are susceptible to develop drug- induced cognitive impairment (loss of the ability to reason) than other healthy adults.
Medications with strong anticholinergic side effects, such as antihistamines that cause drowsiness, are well known for causing acute cognitive impairment in individuals with dementia. Anticholinergic-like effects, such as urinary retention and dry mouth, also have been identified in drugs not typically associated with major AC side effects such as narcotics (powerful pain relievers) and benzodiazepines (generally used as tranquilizers or for sleep).
These drugs also are important causes of acute confusional episodes. The factors that may determine whether a patient will develop cognitive impairment when exposed to ACs include:
1. the number of AC drugs and the doses of the drugs used;
2. baseline cognitive function (determines susceptibility);
3. the individual's response to medications (sensitivity and metabolic processing as determined by their liver and kidney function status).
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