How dementia affects medicines use and everyday pharmacy care

In pharmacy practice, dementia often appears through problems with medicines rather than through a diagnosis label. A person may know who they are and what they want but struggle with the practical steps needed to take medicines safely and consistently.

Common medicines-related effects

• Memory and routine problems: forgetting doses, repeating doses, missing refills, or being uncertain whether a dose has been taken.
• Difficulty understanding instructions: printed labels, timings, warnings and follow-up advice may be harder to process.
• Manual dexterity problems: opening packets, using inhalers, applying patches, measuring liquids or handling eye drops can become difficult.
• Communication and symptom-reporting problems: the person may have trouble describing side effects, pain, dizziness, constipation or swallowing difficulties.
• Changes in eating and swallowing: these affect choice of formulation, adherence, hydration and safety.

Medicines can sometimes worsen cognitive problems

NICE advises being aware that some commonly prescribed medicines increase anticholinergic burden and may impair cognition. Confusion or decline can therefore be caused or worsened by the medicines themselves, not only by dementia progression.

This is also relevant for self-medication. Sedating or anticholinergic OTC products can increase confusion, risk of falls, constipation or urinary retention in older people and those with cognitive impairment.

Medicines review considerations

Dementia affects more than memory. In pharmacy practice it can change how people understand, organise, handle, remember and describe their medicines, which is why practical medicines support matters.