One of the greatest drivers of polypharmacy is the fragmentation of modern healthcare. Many patients, especially those with long-term illnesses, see several different specialists. You might go to a cardiologist, a rheumatologist, and a urologist, and each doctor prescribes a new medicine without a comprehensive check of your full, current medication list.
Often, doctors fail to ask a simple but essential question: “Are we treating a real disease, or are we treating a symptom caused by another pill I or someone else prescribed?”
Bad drug reactions are a catastrophic problem. They cause about 10% of all hospital stays and are shockingly cited as the fourth leading cause of death in the world! Yet, studies suggest that more than 90% of drug side effects are never properly reported or documented by patients or doctors. Patients simply stay quiet, they feel worse and worse, and they never think to ask if the very medicines meant to help are actually the source of their problems. This silence is dangerous and underscores why talking to your doctors is absolutely critical.
Protecting Your Brain: Diet and Proactive Steps
The path toward mitigating medication-related dementia risk involves proactive steps focusing on medication management, diet, and lifestyle changes.
1. Medication Review and Deprescribing
This is the most crucial step. Doctors, and often more effectively, pharmacists, should regularly check and adjust medications, especially for older patients, to ensure they are only taking what is truly necessary.
- Deprescribing: This clinical practice involves systematically reducing or stopping medications that are no longer beneficial or may be causing harm. It requires a doctor’s guidance, but patients should initiate the conversation, asking: “Can we safely reduce or stop this medication?”
- Pharmacist Consultation: Pharmacists are experts in drug interactions. Schedule a full medication review with your local pharmacist to identify potential conflicts and unnecessary prescriptions.
2. Alternative Therapies
Whenever possible, look into non-drug treatments for common issues. Chronic conditions often driving polypharmacy—like insomnia, anxiety, and long-term pain—respond very well to non-pharmacological interventions.
- Insomnia and Anxiety: Instead of relying on benzodiazepines or strong anticholinergic sleep aids, consider Cognitive Behavioral Therapy for Insomnia (CBT-I), stress management techniques, and practicing strict sleep hygiene.
- Chronic Pain: Physical therapy, exercise, massage, and acupuncture can often manage long-term pain with zero cognitive side effects.
3. A Healthier Brain Diet
One key thing that is often overlooked when discussing medication risk is the foundational role of diet. Eating poorly and consuming highly processed foods creates the underlying inflammation and vascular damage that makes the brain more vulnerable to the negative effects of drugs.
Research shows that a diet rich in whole, unprocessed foods can help keep your brain working well and lower your risk of dementia by:
- Boosting BDNF: Brain-Derived Neurotrophic Factor (BDNF) is a protein that promotes the growth of new neurons and synapses. Diets rich in omega-$3$s and polyphenols (found in the Mediterranean diet) increase BDNF.
- Reducing Chronic Inflammation: Diets high in refined sugar and poor fats fuel systemic inflammation, while diets focused on fruits, vegetables, and healthy fats (like the Mediterranean diet or a simple Ketogenic approach) help quell it.
- Supporting Mitochondria: A clean, nutrient-dense diet provides the brain’s powerhouses (mitochondria) with the clean fuel they need to function optimally.
My strongest suggestion is to educate yourself deeply on this topic. Read books, consult registered dietitians, and become proficient in practicing these healthy eating plans.
