“Senior moments,” in which older people forget with they were looking for, or can’t come up with the word they’re looking for, are often treated lightly, as a common effect of aging. But the very real possibility of Alzheimer’s and other dementias
is no laughing matter.
We know that being physically active, and avoiding such cardiovascular risk factors as smoking and high blood pressure, are good ways to protect our cognitive faculties as we age. However, according to the National Academy of Medicine we should add one more precaution to our list: manage our medications.
Most seniors have at least two chronic conditions that require medication; that number increases with age. The problem is that many medications have side effects that can mimic or cause mental decline. Moreover, medications may interact; the more medications a senior takes, the more likely an adverse interaction is.
At the moment, standard medical school education does not offer extensive training in geriatrics, and doctors are not always aware of the risks posed by the prescriptions they are writing for seniors.
As always, it is smart to be one’s own advocate, and take the effort to read the very small print that comes with every new medication. In addition, be on the lookout for the following four commonly prescribed medications, all of which affect cognitive function:
These medications are most commonly used to treat anxiety, panic disorders, insomnia, and seizures, though they do have other uses.
Common benzodiazepines include Ativan (lorazepam), Restoril (temazepam), Valium (diazepam), and Xanax (alprazolam).
Ativan, which is used for insomnia, is particularly known to affect cognition.
If you or a loved one have been prescribed one of these medications, don’t panic. The worst thing you could do is stop them suddenly. Discuss with your healthcare provider whether your cognitive function suggests you need to stop taking these medications. If so, you will need to be weaned off them slowly, and under medical supervision.
Often referred to as z-drugs, non-benzodiazepines are similar in effect to benzodiazepines. While they are chemically unrelated to benzodiazepines, they are often prescribed for the same medical conditions.
The most common nonbenzodiazepines are the sleep aids Ambien (zolpidem), Lunesta (zaleplon), and Sonata (eszopiclone).
As with the benzodiazepines, if it is important to stop these medications, it is important to do so slowly and under medical supervision.
These versatile drugs are prescribed for a variety of conditions, from Parkinson’s to incontinence to Chronic Obstructive Pulmonary Disorder (COPD). They also include over-the-counter sleep medications, as well as sedating forms of antihistamines, such as Benadryl. It is important to be aware that common over-the-counter pain medications, such as Tylenol, often come in sedating formulations. The names of these formulations usually reference nighttime: for example Tylenol PM and NyQuil.
Though these medications are both useful and versatile, the American Geriatrics Society warns that they produce strong side effects in seniors, and has issued cautions regarding their use in seniors. They produce a range of side effects, including cognitive side effects such as memory loss, confusion, and general worsening of cognitive function. They have also been linked to and increased risk of dementia.
Not all anticholinergics are the same, however. The Therapeutic Research Center has published a list that charts low- and high-anticholinergic medications for different conditions. If a senior needs a medication on the list, they are advised to use a low-anticholinergic formulation.
These medications are often used to manage behavioral issues such as aggression, anxiety, insomnia, and wondering, in Alzheimer’s and dementia patients.
The most common antipsychotics used in geriatrics are Abilify (aripiprazole), Risperdal (risperidone), Seroquel (quetiapine), and Zyprexa (olanzapine). Haldol (haloperidol), an older antipsychotic medication, is also prescribed for behavioral disturbances.
All antipsychotic medications diminish cognitive function. Haldol and Risperdal are the top two antipsychotics shown to increase mortality in dementia patients.
According to US Government Accountability Office (GAO) reports, up to one-third of dementia patients are prescribed antipsychotics. The GAO agrees with the recommendations of the US Department of Health and Human Services that nonpharmacological interventions be attempted for disruptive dementia patients before resorting to medication. Although these interventions, such as identifying the triggers of behavioral disturbances, are more difficult to implement than prescribing a pill, but they should nevertheless be the first line of treatment for distressing behaviors in dementia patients.
The best way to avoid harmful medications, particularly for people with multiple conditions, is to be in the care of a staff that is trained in geriatrics, and has had years of experience helping seniors retain cognitive function. The highly-trained, experienced staff at Laurel Bay Health and Rehabilitation Center, in the scenic beach town of Keansburg, NJ, is dedicated to the best possible care for our residents, which includes monitoring medications, and being aware of medication interactions, as well as medication-food interactions. We provide the best possible care for senior cognition, taking a restorative approach to the senior years by offering a variety of activities, physical and social, to keep seniors physically, emotionally, and mentally healthy.
Laurel Bay prides itself on its caregiver training, and the compassion with which staff treat all patients, particularly our most vulnerable patients, those in the Memory Care Unit.
If you have concerns about care for yourself or your loved one, contact us at 732-364-7100 or by clicking here.
Or better yet, come see for yourself. Contact us to schedule a tour by clicking here or by calling (372) 787-8100.