Mol Psychiatry

Some common medication classes may influence dementia risk

August 19, 2025

Current evidence doesn’t support repurposing systemic medications solely for dementia prevention. However, proactive hypertension management is recommended to reduce all-cause dementia risk. Anticholinergic burden should be minimized, especially in patients with cognitive impairment. Routine assessment of anticholinergic exposure and consideration of safer alternatives is advised during clinical encounters.

Study details: This umbrella review synthesized findings from 68 meta-analyses across 11 drug categories, focusing on human studies evaluating systemic medications and dementia risk. Most data were observational, with limited randomized-controlled trial evidence. Study quality and certainty were assessed using AMSTAR-2 and GRADE frameworks.

Results: Moderate-certainty evidence supports a reduced dementia risk with antihypertensives, statins, SGLT2 inhibitors, and GLP-1 RAs. Anticholinergic drugs are associated with a moderate-certainty increased risk, with a dose-response relationship observed. Randomized data specifically support hypertension treatment as protective, with no significant difference between antihypertensive classes; risk reduction correlates with blood pressure control rather than drug type. Evidence for other drug classes (e.g., psychotropics, benzodiazepines) remains observational and confounded by indication.

Source:

Belessiotis-Richards C, et al. (2025, July 24). Mol Psychiatry. Systemic medications and dementia risk: a systematic umbrella review. https://pubmed.ncbi.nlm.nih.gov/40707785/