Is long-term painkiller use tied to dementia?
Many people take painkillers for years to manage ongoing aches and pains. These drugs help with everything from arthritis to back problems. But some wonder if using them a long time raises the risk of dementia, a condition that harms memory and thinking skills. The answer is not simple. It depends on the type of painkiller.
Not all painkillers carry the same worry. Common over-the-counter ones like acetaminophen or ibuprofen do not show a strong link to dementia in studies. The real concern points to a group called anticholinergic drugs. These block a brain chemical called acetylcholine, which helps with memory and learning. Some painkillers fit this group, like those with diphenhydramine found in sleep aids mixed with pain relievers, such as Tylenol PM or Advil PM. Long-term use of anticholinergics in people over 60 may increase dementia risk.[1]
A large study in JAMA Internal Medicine looked at nearly 60,000 people with dementia and compared them to over 225,000 without it. Those who took anticholinergics for years had a higher chance of dementia. The study noted short-term effects like confusion and memory loss, but long-term use might do more harm.[1] Another report found that high use of these drugs, combined with certain brain markers, raised dementia risk six times higher.[2]
Doctors see this most in older adults. Drugs for allergies, sleep, or bladder issues often share this anticholinergic effect. Painkillers are not the main focus, but some overlap, especially combo pills for nighttime pain. Experts say to use the lowest dose for the shortest time. Talk to a doctor about safer options if pain lasts long term.[1]
Awareness helps. Checking medicine labels and asking pharmacists can spot anticholinergics. Lifestyle steps like exercise and good sleep also protect the brain.
Sources
https://medshadow.org/conditions-treatments/alzheimers-dementia/the-link-between-dementia-alzheimers-and-common-meds/
https://pmc.ncbi.nlm.nih.gov/articles/PMC12695687/
https://www.neurologyadvisor.com/news/immediate-neuro-rehabilitative-therapy-after-tbi-cuts-alzheimer-disease-risk/
