5 things to know when taking 5 or more medications

It's not completely clear how the drugs might increase dementia risk, but a 2016 study found that the brains of those on long-term anticholinergics had atrophied and the hollow spaces

inside increased. The neurons also had reduced ability to metabolize glucose. The higher the drug exposure, the more pronounced the effect. Anticholinergics can also counteract the

medications given to improve memory and thought in Alzheimer's disease, making a bad situation even worse. Three common Alzheimer's drugs (brand names Aricept, Exelon and Razadyne)

belong to a class called cholinesterase inhibitors. They work by increasing acetylcholine, a chemical that allows the body's nerve cells to communicate with each other, by preventing

its breakdown. Anticholinergics do the opposite. They block the ability of acetylcholine to exert its effect, lowering nerve signaling, thereby decreasing whatever activity those nerves

control. OTHER HIDDEN DANGERS LURK IN COMMON MEDICINES Cognitive changes aren't the only potential side effects of these medications, said Shanna Trenaman, a pharmacist at Dalhousie

University in Halifax, Nova Scotia, who specializes in geriatrics. Plenty of studies have found that anticholinergics can increase stomach upset and cause constipation and urinary retention.

Some sleep aids (including a number that are sold over the counter) also have anticholinergic effects; these have been linked to increased risk of car wrecks, falls and other injuries,

Trenaman says. And medication interactions are possible with these, as well. "I would encourage everyone to think critically about whether or not they need to take medication for

sleep,” Trenaman told AARP. “They help you fall asleep only about seven minutes faster on average, so is that worth these risks?” If you are taking something to help you sleep and decide to

discontinue it, do it with guidance from a health care professional who can help you taper off the medication slowly. A HEALTH CARE PROVIDER SHOULD REVIEW YOUR MEDICATIONS OFTEN Experts

interviewed for this article have a unanimous recommendation: Be proactive in your medication decisions. Older adults managing multiple health conditions may see several doctors — and each

may be unaware of what the others have prescribed. Recently there's been greater attention focused on the concept of deprescribing — or “evaluating people's medications,

consciously assessing whether it's really needed, and planning how best to reduce and discontinue it,” Schneider says. It's important to note, however, that patients should never

stop taking a drug without consulting a doctor, as this can be dangerous. Instead, the three experts recommend at least an annual review of medications with your main physician. Bring all of

your medications in — don't forget about any over-the-counter medicines you are taking, plus vitamins and supplements — and talk about potential interactions and which drugs you may no

longer need. "There's a perception that all over-the-counter medications are as safe as water, but that's just not true. Antihistamines, anticholinergics and sleep aids are

just as potent over the counter as they are by prescription, and they are big contributors to this issue,” Schneider says. Your pharmacist can also help answer any medication questions,

especially when it comes to spotting potentially troublesome drug combinations.