Why One in Four Older Americans May Be Prescribed Risky Brain-Altering Medications

A new study released by researchers at UCLA in early 2026 is bringing attention to an issue many families quietly carry in their hearts: how to keep a loved one safe, comfortable, and truly cared for as memory changes begin to unfold. Despite years of medical guidance urging caution, many older adults living with dementia continue to receive medications that may create more risk than relief.

This research is not simply about statistics or prescriptions. It is about people. It is about parents, spouses, grandparents, and friends whose lives have shaped our own. And it is about the responsibility we share to protect them with both compassion and clarity.

For families walking alongside someone experiencing memory loss, the journey can feel uncertain at times. Yet it is also a journey filled with moments of connection, resilience, and love. Knowledge does not remove the challenge, but it can bring reassurance, direction, and a sense of steadiness when decisions feel overwhelming.

What the UCLA Study Found

According to research published in JAMA and summarized by UCLA Health, approximately one in four Medicare beneficiaries with dementia is prescribed medications that affect brain function and may increase the risk of confusion, falls, and hospitalization.

Researchers reviewed national survey data connected to Medicare claims between 2013 and 2021. They compared prescribing patterns among older adults with normal cognition, those with cognitive impairment but no dementia diagnosis, and those living with dementia.

The findings revealed a clear pattern. Individuals experiencing cognitive changes were more likely to receive medications considered potentially inappropriate for their condition.

About 25 percent of adults with dementia were prescribed these medications. Roughly 22 percent of those with cognitive impairment received them. In comparison, about 17 percent of cognitively healthy older adults were prescribed the same drugs.

These numbers can feel sobering. Yet they also offer something important: awareness. Awareness creates the opportunity to ask questions, seek guidance, and make thoughtful choices that support safety and wellbeing.

What Are “Brain-Altering” Medications?

The study focused on medications that affect the central nervous system. These drugs influence brain chemistry, mood, behavior, and sleep. They are commonly used in healthcare and can be appropriate in certain situations, especially when symptoms are severe or distressing.

Examples include certain antidepressants with anticholinergic effects, antipsychotic medications, benzodiazepines often prescribed for anxiety or sleep, non-benzodiazepine sleep medications, and barbiturates.

Medical professionals have long recommended careful use of these medications in individuals with dementia because they can sometimes increase confusion, raise fall risk, or reduce mobility.

Researchers also found that more than two-thirds of patients receiving these prescriptions did not have clear documentation explaining the medical reason for their use. That finding highlights the importance of ongoing review and open communication between families and healthcare providers.

Why These Medications Can Be Risky for People with Dementia

People living with dementia are often more sensitive to medications than others. Their brains and bodies are already working harder to process information and maintain balance. When medications alter brain activity, the effects can be stronger than expected.

Potential side effects may include increased confusion, dizziness, falls, sedation, or a decline in physical strength. For families, these changes can feel sudden and frightening. A loved one who seemed steady last week may appear unsteady today. A person who was engaged in conversation may seem unusually withdrawn.

But it is important to remember this: not every change is permanent, and not every symptom is part of the disease itself. Sometimes adjustments to medications can lead to meaningful improvement in comfort, clarity, and daily functioning.

That possibility is where hope lives.

The study showed encouraging movement in the right direction. Prescribing of these medications declined from about 20 percent of older adults to 16 percent during the nine-year period studied. Much of that progress came from reduced use of certain sleep and anxiety medications.

This shift reflects growing awareness among healthcare providers and caregivers. It shows that change is possible when knowledge spreads and conversations happen.

Still, prescribing rates remain highest among individuals with cognitive impairment, the very group most vulnerable to complications. Researchers concluded that there are significant opportunities to improve safety and quality of care for millions of older Americans.

In other words, there is more work to do and meaningful progress is already underway.

Why This Matters for Families and Caregivers

For families supporting someone with dementia, medication decisions often happen during emotionally charged moments. A loved one may become restless at night, anxious during the day, or confused after a hospital stay. In those moments, a prescription can feel like the fastest way to bring relief. Sometimes it is the right decision.

But this research reminds us that medication management is not a single decision. It is an ongoing conversation.

Families should feel empowered to ask questions such as why a medication is being prescribed, whether non-drug approaches might help, what risks the medication may pose for cognition or falls, and whether the dosage can be safely adjusted over time.

These conversations are not about challenging providers. They are about partnering in care and ensuring that treatment decisions reflect both medical expertise and deep personal understanding of the individual receiving care.

A Broader Takeaway: Safety Requires Oversight

This study highlights a truth many families come to understand through experience. Dementia care is not only medical. It is relational. It involves communication, coordination, and trust.

Medication safety, daily supervision, financial management, and healthcare decisions are all connected. When families have the right support and legal authority in place, they are better equipped to advocate, make informed choices, and respond to changing needs with confidence.

Planning ahead is not about expecting the worst. It is about creating stability in the midst of uncertainty.

Legal tools such as a Durable Financial Power of Attorney, Advance Healthcare Directive, and trust-based planning allow trusted individuals to step in when needed, ask the right questions, and protect the person they love with clarity and compassion.

The Takeaway

Memory loss is one of the most emotional journeys a family can face. It can bring worry, grief, and moments of helplessness. Yet it can also reveal extraordinary strength, patience, and love.

This research serves as a reminder that thoughtful care is not only about treatment. It is about attentiveness. It is about advocacy. It is about surrounding vulnerable individuals with people who are willing to ask questions, stay engaged, and act with intention.

There is hope in preparation.
There is hope in partnership.
And there is hope in the small, steady steps families take every day to protect the dignity and safety of those they love.

When cognitive decline progresses, individuals may no longer be able to question treatments or advocate for themselves. That reality places greater responsibility on:

• family caregivers,
• healthcare proxies,
• agents under powers of attorney, and
• professional care teams.

Clear legal planning and active involvement in care decisions can help ensure treatments align with a person’s health goals and overall well-being.

 

Planning Takeaway

The UCLA findings serve as a reminder that protecting older adults involves more than medical treatment alone. Effective protection includes:

• thoughtful healthcare decision-making authority,
• regular medication reviews,
• coordinated communication between families and providers, and
• proactive advocacy as cognitive changes emerge.

As dementia diagnoses continue to rise nationwide, informed families play an increasingly important role in ensuring care decisions prioritize both safety and dignity.