A University at Buffalo study found that potentially cognition-impairing medication exposure in older adults with cognitive disorders dropped to 29.3% in 2022.
On August 4, 2026, researchers from the University at Buffalo published a study in the Journal of the American Geriatrics Society showing that the use of potentially cognition-impairing medications among independently living older adults with cognitive disorders declined between 2011 and 2022.
The research team analyzed data from the Medical Expenditure Panel Survey covering an eleven-year period. They focused on 2,796 participants aged 65 and older who lived independently and had cognitive disorders. These participants represented an estimated 29.7 million older Americans across the study window. The primary goal was to track exposure to medications that can affect the central nervous system.
Medications were classified as potentially inappropriate if participants had at least one filled prescription during the calendar year. The categories included anticholinergics, antipsychotics, benzodiazepines, and hypnotics. The University at Buffalo release notes that these medications are often used for conditions like anxiety, psychosis, and sleep problems. The study found that the proportion of people exposed to at least one of these medications dropped from 39.3 percent in 2011 to 29.3 percent in 2022.
This ten-percentage-point decrease is a positive trend in prescription management for older adults. The data showed specific statistically significant declines for certain drug classes. Benzodiazepine exposure declined at an annual percentage change of 6.8 percent. Exposure to non-benzodiazepine hypnotics declined at an annual percentage change of 10.6 percent.
The study also examined how these medications related to healthcare use and overall wellbeing. Exposure to these potentially inappropriate medications was associated with higher odds of poor mental-health-related quality of life. The adjusted odds ratio for this association was 1.72. Non-benzodiazepine hypnotic exposure showed the largest reported association with an adjusted odds ratio of 2.47.
Medication exposure also correlated with increased acute healthcare usage. The researchers noted an adjusted incidence-rate ratio of 1.41 for emergency-department visits. Hospitalizations also saw an association with an adjusted incidence-rate ratio of 1.38. The study did not find an association between medication exposure and outpatient visits.
Haowen Hsu, PharmD, of the University at Buffalo’s Department of Pharmacy Practice led the research. He noted that older adults with cognitive disorders often have existing central-nervous-system vulnerabilities. Taking medications that also act on the central nervous system can complicate these vulnerabilities. Hsu welcomed the decline in overall exposure over the study period.
The ten-percentage-point drop is a positive development, but nearly one-third of the target population remained exposed to these drugs in 2022. This ongoing exposure is a focal point for the UB Patient Safety Learning Laboratory and Team Alice. Team Alice is an interdisciplinary patient-safety initiative at the university. David Jacobs, PharmD, PhD, serves as an associate professor of pharmacy practice and principal investigator for the initiative.
Jacobs noted that older adults with cognitive disorders may be especially unable to tolerate medications that worsen memory or thinking. The authors characterized this medication exposure as a possible marker of clinical vulnerability. They suggested that exposed patients might benefit from closer clinical monitoring. The researchers also highlighted that an aging population with multiple chronic conditions often leads to multiple prescriptions.
These findings create a practical opportunity for older adults to discuss their current prescriptions with a doctor. The university release suggests that medication safety requires coordination among healthcare providers, home-care nurses, and community pharmacists. A structured medication review is a proactive step for anyone noticing memory, attention, or thinking problems. This step is highly recommended for older adults taking several different prescriptions simultaneously.
When scheduling a review, you should bring a complete list of all your medications. This list must include daily prescriptions, over-the-counter products, and occasional sleep or allergy medicines. Because the study measured exposure to anticholinergics and hypnotics, a review should look beyond treatments marketed exclusively for memory. Asking your doctor to assess your entire medication routine is a fundamental part of proactive brain health.
The researchers suggest four practical questions to ask your care team during this review. First, ask what each medication is specifically designed to treat. Second, confirm whether the medication is still medically necessary. Third, ask if the current dose or frequency could be safely reduced. Finally, inquire if there is a safer alternative for your specific health situation.
You can also ask your doctor about the cumulative burden of your prescriptions. The University at Buffalo release points to the Drug Burden Index as one clinical tool that doctors can use to assess central-nervous-system medication burden. Reviewing these factors fits perfectly into broader cognitive health and protection articles that emphasize routine medical checkups. Monitoring for daytime sedation, new confusion, balance problems, and falls can help you provide accurate information to your doctor.
It is crucial to evaluate this data carefully and avoid jumping to extreme conclusions. The research was a cross-sectional analysis, which means it can identify associations but cannot prove causation. The study cannot establish that these medications directly caused poorer mental quality of life, emergency visits, or hospitalizations. The authors openly acknowledged the possibility of reverse causation in their findings.
Reverse causation means that people with poorer health or more severe symptoms might be more likely to receive these prescriptions in the first place. A filled prescription also does not prove that a person took the medication continuously or experienced a cognitive side effect. The study defined exposure simply as having at least one filled prescription during the calendar year. Furthermore, the researchers did not determine the exact reasons why overall medication exposure declined between 2011 and 2022.
The classification of a drug as potentially inappropriate does not mean it is always inappropriate for every single patient. A medication might still be clinically justified for a specific person after a doctor considers their symptoms, prior treatment responses, risks, and benefits. The study evaluates population-level exposure rather than making individualized prescribing judgments. These results also apply specifically to community-dwelling adults aged 65 and older with cognitive disorders.
You must never stop taking a prescribed medication abruptly based on observational studies. Deprescribing is a structured medical process that requires strict supervision from your healthcare team. Hsu described deprescribing as removing an inappropriate medication, reducing its dose, or replacing it with a milder alternative when clinically appropriate. Independent changes to your medication routine can be dangerous and are strongly discouraged.
The decline in potentially cognition-impairing prescriptions indicates a positive shift in how doctors manage older adult care. However, the fact that 29.3 percent of the study population remained exposed highlights an ongoing need for vigilance. As we age, our bodies process medications differently, making routine reviews a vital part of healthy aging. By understanding the potential impact of these drugs, you can take a more active role in your healthcare decisions.
Managing memory and focus involves looking at your entire physical routine, including the medicines you take every day. Staying informed empowers you to ask better questions and build a stronger relationship with your primary care provider. Reading reliable memory and cognitive performance resources can help you prepare for these conversations. Ultimately, clear communication with your doctor remains your best tool for protecting long-term cognitive clarity.
The goal is not to eliminate all medications, but to confirm every prescription still serves a clear and medically justified purpose. This careful balance is central to the mission at FitBrainLab, where we encourage evidence-based conversations about aging. Addressing potentially inappropriate medications proactively can help you maintain your independence, safety, and mental sharpness in the years ahead.
Balancing prescription needs with long-term memory protection requires careful conversations with your healthcare provider. Uncertainty about which everyday habits may support cognitive health often complicates medication reviews, but FitBrainLab translates complex evidence clearly so you can prioritize established guidance over unproven claims. Explore Resources
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