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6. INCONTINENCE DRUGS (ANTICHOLINERGICS) WHY THEY ARE PRESCRIBED: These medications are used to relieve symptoms of overactive bladder and reduce episodes of urge incontinence, an urge to

urinate so sudden and strong that you often can’t get to a bathroom in time. EXAMPLES: darifenacin (Enablex), oxybutynin (Ditropan XL), solifenacin (Vesicare), tolterodine (Detrol) and

trospium (Sanctura). Another oxybutynin product, Oxytrol for Women, is sold over the counter. HOW THEY CAN AFFECT MEMORY: Patients who take anticholinergics can have complications with their

long-term memory, says Merrey. These medications have been associated with an increased risk of dementia, and that heightened risk can persist even after the medication has been

discontinued. That’s because these drugs block the action of acetylcholine, a neurotransmitter that mediates all sorts of functions in the body. In the bladder, anticholinergics prevent

involuntary contractions of the muscles that control urine flow. In the brain, they inhibit activity in the memory and learning centers. The risk of memory loss is heightened when the drugs

are taken for more than a short time or used with other anticholinergic drugs. Older adults are particularly vulnerable to the other adverse effects of anticholinergic drugs, including

constipation (which, in turn, can cause urinary incontinence), blurred vision, dizziness, anxiety, depression and hallucinations. ALTERNATIVES: As a first step, it’s important to make sure

that you have been properly diagnosed. Check with your doctor or other health professional to see if your urinary incontinence symptoms might stem from another condition (such as a bladder

infection or another form of incontinence) or a medication (such as a blood pressure drug, diuretic or muscle relaxant). Once these are ruled out, try some simple lifestyle changes, such as

cutting back on caffeinated and alcoholic beverages, drinking less before bedtime and doing exercises to strengthen the pelvic muscles that help control urination. Some urologists are

treating overactive bladder with Botox injections to help the muscle relax. Solutions beyond the medicine aisle can also come in handy. “I’ve been really thrilled with the improvements in

protective [undergarment] items. They’ve really come a long way,” says K. Ashley Garling-Nañez, clinical assistant professor at the University of Texas at Austin College of Pharmacy. “There

are a lot more options for active adults.” 7. ANTIHISTAMINES (FIRST GENERATION) WHY THEY ARE PRESCRIBED: These medications are used to relieve or prevent allergy symptoms or symptoms of the

common cold. Some antihistamines are also used to prevent motion sickness, nausea, vomiting and dizziness, and to treat anxiety or insomnia. EXAMPLES: brompheniramine (Dimetane),

chlorpheniramine (Chlor-Trimeton), clemastine (Tavist), diphenhydramine (Benadryl), promethazine (Phenergan) and hydroxyzine (Vistaril). HOW THEY CAN AFFECT MEMORY: These medications

(prescription and over-the-counter) inhibit the action of acetylcholine, a chemical messenger that mediates a wide range of functions in the body. In the brain, they inhibit activity in the

memory and learning centers. ALTERNATIVES: Newer-generation antihistamines such as loratadine (Claritin) and cetirizine (Zyrtec) are better tolerated by older patients and do not present the

same risks to memory and cognition. OTHER MEDICATIONS WORTH NOTING CORTICOSTEROIDS: These anti-inflammatory drugs, which are used to treat rheumatoid arthritis, lupus and other conditions,

can cause confusion and memory loss in patients on high doses, Devanand says. They can also trigger depression. HEARTBURN MEDICATIONS: Some recent studies, including one from 2022 published

in _BMC Medicine,_ have found a link between medications commonly used to treat gastroesophageal reflux disease (GERD), heartburn and peptic ulcers with an increased risk of dementia. If you

take an over-the-counter proton-pump inhibitor, Garling-Nañez says it’s important to use the medication in moderation and for short amounts of time. “Anything over the counter, try not to

use it for more than two weeks at a time is typically what we recommend,” she says. CANNABINOIDS: Access to cannabis and use of the drug have grown in recent years. Mounting research shows

that cannabis may have an effect on our cognition. A study published in The American Journal of Psychiatry in March 2022 followed approximately 1,000 individuals and found that long-term

cannabis users showed cognitive deficits, as well as memory and attention problems. CONCERNS? WHAT TO DO Worried medications could be messing with your memory? Start by asking others closest

to you if they’ve noticed any issues. And don't hesitate to talk to your doctor. Know that the number of drugs you’re taking could be affecting your memory as well. Taking multiple

medications — a practice known as polypharmacy — has been linked to lower memory function in older adults, as well as an increased risk for delirium. A report from the Lown Institute shows

that 42 percent of older adults take five or more prescription medications. If you’re concerned about the number of pills crammed into your pillbox, Garling-Nañez suggests asking your doctor

if every single one of them is still necessary or if there are any you can stop taking. This process, known as deprescribing, involves reducing the dose, gradually tapering off, or

eliminating drugs that may contribute to memory loss.  Another approach is switching to a different class of medication with fewer potential complications. Ask your provider if you’re on the

lowest effective dose to manage your condition. Higher doses of certain medications can increase the risk of memory loss, so it's essential to find the right balance. “As a pharmacist,

I do a lot of work with the provider or the family to replace the medication with healthy lifestyles,” says Merrey. “There’s lots of non-pharmacologic recommendations to do and add those in

as you’re tapering down certain medications.”  In any case, if you want to lower the dosage of a drug or stop taking a medication, be sure to do so under the supervision of your doctor –

don’t do it on your own. MEDICATIONS, DEMENTIA AND SUNDOWNING Although sundowning syndrome – a state of confusion or agitation that occurs late in the afternoon and stretches into evening –

is typically linked to Alzheimer’s, it can occur with any type of dementia. And medications like anticholinergics, tricyclic antidepressants, antihistamines and anti-Parkinson’s drugs can

trigger or worsen its symptoms. Other substances – alcohol and nicotine, for example – can also cause sundowning, says Merrey. BETA-BLOCKERS AND YOUR MEMORY While there is no evidence that

beta-blockers – prescribed for heart failure, angina, certain heart rhythm disorders and sometimes high blood pressure – contribute to long-term cognitive decline or dementia, they can make

some people feel “fatigued,” “foggy” and “not their sharpest,” Lloyd-Jones says. If you experience these effects, don’t stop taking your medication. Talk to your doctor about switching to a

different beta-blocker with a slightly different chemical composition, Lloyd-Jones suggests. _Editor’s note: This story, originally published Feb. 9, 2016, has been updated to include new

information. _ _Zachary Cox is a pharmacist and Professor at Lipscomb University College of Pharmacy and Adjunct Professor at Vanderbilt University School of Medicine in Nashville,

Tennessee. _