Medication and Cognition

Adverse cognitive effects may occur when any of the medications in the Medications List are taken at any dose.

• HIGH RISK medications have the strongest anticholinergic effects, and may be considered as the MOST LIKELY to affect cognition.
• LOWER RISK medications have less anticholinergic effect, and are more likely to affect cognition when used in combination with other medications in the Medications List, or at high doses.

Particularly high-risk circumstances include:

• When a medication from the Medications List is taken at a high dose and/or in combination.
• When any new medication is started, stopped, or the dose is changed.
• When there are medication interactions.
• During times of increased stress, e.g. illness, infection, pain.
• When a person has reduced ‘cognitive reserve’, e.g. cognitive impairment, frailty.

Medications List. Selected medications that may adversely affect cognition that are commonly prescribed in Australian residential aged care.

Note: Many of these medications may also have sedative effects.