As people age, they often rely on medications to manage chronic conditions. However, long-term use of certain drugs may raise the risk of developing Alzheimer’s disease (AD). Below are 10 types of drugs that may trigger or worsen AD symptoms and should be used with caution.

1. Anticholinergic Drugs

These include some antipsychotics, anti-epileptic drugs, and medications for Parkinson’s disease. Acetylcholine helps the brain process learning and memory, but anticholinergic drugs interfere with its action, which can lead to cognitive decline. Medications like benztropine, atropine, belladonna alkaloids, and scopolamine are common examples of such drugs.

2. Antihistamines

Histamine helps regulate wakefulness in the brain.Older antihistamines such as diphenhydramine and chlorpheniramine can enter the brain, leading to sleepiness and reduced mental sharpness. These effects are more pronounced in the elderly compared to second-generation antihistamines.

3. H2 Receptor Antagonists

Used to treat acid reflux and ulcers, drugs like cimetidine and ranitidine may cause central nervous system side effects, including confusion, delirium, and disorientation. Older adults using these drugs may face an increased risk of cognitive impairment.

4. Sedative-Hypnotics

Long-term use of sedatives such as nitrazepam or barbiturates may exacerbate AD or trigger its progression. These drugs depress brain activity to aid sleep, but chronic use can lead to dependence and cognitive deterioration.

5. Anti-Epileptic Drugs

While essential for controlling seizures, some studies suggest that long-term use of certain anti-epileptics may be linked to cognitive decline and increased AD risk. Though research is mixed, these medications should be used cautiously under medical supervision in older adults.

6. Central-Acting Antihypertensives

Drugs like reserpine and methyldopa lower blood pressure by acting on the brain’s neurotransmitters. However, they may cause sedation, attention deficits, and depression, potentially increasing the risk of AD with prolonged use.

7. Iron Supplements

Iron is vital for health, but excess iron can trigger oxidative stress and harm neurons. In older adults, over-supplementation may lead to iron accumulation in the brain, contributing to neurodegenerative diseases like AD. Iron should only be supplemented under medical guidance.

8. Aluminum-Containing Compounds

Aluminum, a non-essential trace element, may be harmful to the brain when consumed long-term. Antacids containing aluminum hydroxide, for example, can lead to aluminum accumulation in the brain, resulting in neurological damage. Caution is advised when using these products.

9. Digestive system medications

Cimetidine can inhibit gastric acid secretion and has an antihistamine effect, but it can also cause adverse reactions such as delirium, intellectual impairment and drowsiness.

It has also been reported that the aluminum content in the brains of many patients with Alzheimer's disease is 10 to 30 times higher than that of normal people. Therefore, aluminum-containing antacid drugs (such as magnesium aluminum carbonate chewable tablets) should be consumed sparingly or avoided altogether. Long-term use is contraindicated as aluminum agents have neurotoxicity and can induce or aggravate dementia in patients.

10. Traditional Chinese Medicines Containing Cinnabar

Cinnabar contains mercury, which can accumulate in the body and damage the central nervous system if taken long-term. Common cinnabar-containing remedies like Angong Niuhuang Wan and Zixue Dan carry potential neurotoxicity. They should be avoided by older adults and pregnant women.

Conclusion

The development of Alzheimer’s disease is influenced by genetic and environmental factors—and potentially by medication use. Older adults should use medications cautiously, stay in close communication with healthcare providers, and regularly reassess the benefits and risks of their treatments.