Memory Makers or Memory Takers: Medications and Dementia

Visitors to this website and subscribers to our newsletter know that we have been highly critical of the FDA’s approval of anti-amyloid drugs for Alzheimer’s disease (AD).  They are expensive, barely beneficial at slowing cognitive decline and have some serious side effects. There is growing support for a different approach to AD. We were intrigued to read a new systematic review of medications and dementia (Translational Research & Clinical Interventions, Jan. 21, 2025). In this analysis we learned that some drug categories—antimicrobials, vaccines and anti-inflammatories—were associated with a reduced risk of dementia, whereas other medications might increase the risk of dementia. Read on for more details.

Infections, Inflammation and Alzheimer’s Disease:

In 2018 we had the honor to interview Dr. Robert Moir on our nationally syndicated public radio show. He was an Assistant Professor in Neurology at Harvard Medical School and at MGH Neurology Research. He was an innovative thinker and a brilliant investigator.

Dr. Moir and his colleagues proposed that beta-amyloid, the stuff in amyloid plaques, was an immune response to infection, possibly related to the herpes virus (Neuron, July 11, 2018). You can listen to one of our heroes at this link. Just click on the arrow inside the green circle under his picture.  Sadly, Dr. Moir died prematurely of brain cancer in 2019, but the ideas behind his research live on. Dr. Moir’s vision astounded us. A great deal of research has accumulated to suggest that herpes viruses are a risk factor for Alzheimer disease. Here is a recent article on this subject.

Do Cold Sores Increase the Risk for Alzheimer Disease?

Medications and Dementia: Antiviral Treatments vs. AD:

We have been asking this question for quite some time:

Can Anti-Herpes Treatments Prevent Alzheimer’s?

The article titled “Data-driven discovery of associations between prescribed drugs and dementia risk: A systematic review” was published in Translational Research & Clinical Interventions on January 21, 2025. These investigators scoured the medical literature and found 14 studies with “medical records data for more than 130 million individuals and 1 million dementia cases.”

They go on to describe what they did:

“We conducted a systematic review to identify and summarize studies adopting a data-driven approach to investigate the association between prescribed medications and dementia risk.”

What They Found About Medications and Dementia:

These scientists waded through an enormous amount of data. We will first report on which medications seemed to lower the risk for dementia. In doing so, however, we must point out that there was quite a bit of variability between studies. But when you put them all together and slice and dice the data, you come up with an overview.

The authors wrote:

“Overall, we found a lack of consistency between studies in identifying individual drugs which modify risk of all-cause dementia or AD [Alzheimer’s disease]. However, some drug classes with biological plausibility were identified including antimicrobials, vaccines, anti-inflammatories, and antihypertensives for reduced risk.

“Despite the lack of consistency for individual drugs, there are some themes that emerge for drug classes and are consistent with previously published literature and biological plausibility. The association between antibiotics, antivirals, and vaccines and decreased risk of dementia is intriguing. Viral and bacterial infectious causes of common dementias have been proposed, supported by epidemiological data linking infection to dementia risk, antiviral drugs have been identified as some of the most promising repurposed drugs for dementia, and there is increasing interest in vaccination as being generally protective. Our findings support these hypotheses and lend further weight to these agents as being potentially disease-modifying or preventative for dementia.”

The authors mention blood pressure medications as being potentially beneficial, but their findings in this regard were a bit confusing and contradictory. Losartan (an ARB or angiotensin receptor blocker) seemed to be one of the anti-hypertensive medications that was beneficial.

Valacyclovir seemed to be the antiviral linked to a lower risk of dementia.

They also reported that nondrug approaches might offer promise:

“The strongest negative correlations with dementia or progression of cognitive decline were identified for combinations of herbals, zinc, selenium, magnesium, biotin, vitamin A, lutein, and chromium picolinate.”

Medications and Dementia: Which Drugs Are Worrisome?

After sifting through a lot of research, the authors appeared to conclude that people taking antipsychotic drugs and antidepressants had an increased risk for dementia. Some drugs for diabetes and hypertension also appeared to raise the risk. This appears confusing, since both hypertension and diabetes are linked to AD. But blood pressure drugs and diabetes medications work in different ways. Consequently, the kind of drug being prescribed may make a difference.

The authors mention “urologicals.” These are medications that are prescribed for “overactive bladder.” Most are what we call anticholinergic drugs. That means they interfere with the activity of the critical neurotransmitter acetylcholine. We have written extensively about the link between anticholinergic medications and dementia. Here are some articles that provide more details, potentially problematic medications and the names of anticholinergic drugs:

Anticholinergic Drugs and Dementia: The Link Gets Much Stronger!

Where Can I Find a List of Anticholinergic Drugs?

Are Your Drugs Raising Your Risk for Dementia?

Final Words:

What are we to make of this review of medications and dementia? First, what we put in our bodies has an impact for benefit or harm. There is no longer any doubt that exercise is good for our brains and diet also makes a huge difference. Although you are no doubt getting tired of hearing this, the Mediterranean-style diet appears to help delay dementia. The link to that article will tell you about the research supporting this dietary approach.

As important as lifestyle is in protecting your brain, medications can also impact the risk of developing Alzheimer disease and dementia. This latest research in Translational Research & Clinical Interventions (Jan. 21, 2025) confirms what we have long suspected. Drugs do make a difference!

They can be memory makers or memory takers. If you click on the link to the full text of the article you can scroll to # 6: “Medications associated with reduced dementia risk” and # 7 “Medications associated with increased dementia risk.” Your primary care provider may appreciate a copy of this article. Because it is “open source,” you could print the full text and take it along on your next visit. You may also want to print our list of drugs that have anticholinergic activity at this link.

May We Ask a Favor?

If you found this article of interest, please share it with friends or family members. We do our best to stay on top of the medical literature. That is why we wanted to share the information from the journal Translational Research & Clinical Interventions (Jan. 21, 2025). It is unlikely your physician has time to keep up with such publications unless she is a dementia researcher. Thank you for supporting our work.