How to Recognize Medication Side Effects That Mimic Aging in Seniors

It’s easy to assume that memory lapses, confusion, or sluggishness in an older adult are just part of getting older. But what if those signs aren’t aging at all? What if they’re caused by a pill someone is taking every day? Across Australia and beyond, thousands of seniors are being misdiagnosed with dementia or cognitive decline when the real culprit is a common medication. These side effects don’t just mimic aging-they can be reversed. And recognizing them early can change everything.

What Medications Are Hiding in Plain Sight?

Many drugs prescribed to seniors have side effects that look exactly like the signs of dementia: forgetfulness, trouble focusing, dizziness, or even personality changes. The most common offenders are anticholinergic medications. These drugs block a brain chemical called acetylcholine, which helps with memory, attention, and muscle control. When it’s blocked, the brain slows down-and that slowdown looks a lot like aging.

You’ve probably heard of some of these:

• Diphenhydramine (Benadryl) - used for allergies and sleep
• Oxybutynin (Ditropan) - for overactive bladder
• Tricyclic antidepressants like amitriptyline
• Quetiapine (Seroquel) - sometimes prescribed for sleep or agitation
• Promethazine - for nausea and motion sickness

Here’s the problem: these aren’t rare prescriptions. About 50-70% of seniors take at least one of these. And many don’t even realize they’re on them. A person might be taking Benadryl for allergies, then a bladder pill for incontinence, and a sleep aid that contains the same active ingredient-all without anyone connecting the dots.

How to Tell the Difference Between Aging and Medication Side Effects

True aging changes happen slowly. Dementia from Alzheimer’s or other neurodegenerative diseases doesn’t show up overnight. It creeps in over months or years. But medication side effects? They often appear suddenly.

Ask yourself these questions:

• Did the symptoms start within two weeks of starting a new drug or changing a dose?
• Do they get worse when the medication is taken and improve when it’s skipped?
• Is the person more confused after taking a pill, especially in the evening?
• Are there physical signs too-dry mouth, constipation, blurry vision, trouble urinating?

These are red flags. A senior who was sharp last month but now forgets names, gets lost in familiar places, or seems unusually drowsy might not have dementia. They might have medication fog.

A 2022 study from KFF Health News followed a woman in her late 60s who was diagnosed with severe dementia. Her family was preparing for long-term care. Then, her pharmacist reviewed her meds and found she was on three anticholinergic drugs. After stopping them over six weeks, her memory returned. She went back to gardening, cooking, and remembering birthdays. No brain scan, no therapy-just a medication review.

The Hidden Risk of Polypharmacy

Most seniors aren’t on just one medication. They’re on five, six, or more. This is called polypharmacy. And it’s not just about the drugs themselves-it’s about how they interact.

When you take four or more medications, your risk of a bad reaction jumps dramatically. One drug might cause drowsiness. Another might slow your digestion. A third might blur your vision. Together, they create a perfect storm: dizziness, confusion, falls, and memory loss.

The American Geriatrics Society’s Beers Criteria lists 30+ medications that are generally unsafe for people over 65. It’s not a suggestion-it’s a warning based on real-world outcomes. Yet, only 38% of primary care doctors regularly review all their senior patients’ medications.

And here’s the kicker: many of these drugs were prescribed years ago for conditions that no longer exist. A sleep aid from 2015. A bladder pill from 2018. A painkiller that’s no longer needed. They just sit in the medicine cabinet, quietly doing damage.

What to Do: The 4-Step Plan

You don’t need a specialist to start fixing this. Here’s how to take action:

1. Make a full list of every pill, patch, cream, and supplement your loved one takes-including over-the-counter drugs and herbal remedies. Don’t rely on memory. Check the bottles.
2. Use the ACB scale (Anticholinergic Cognitive Burden). Each anticholinergic drug has a score: 1 (mild), 2 (moderate), or 3 (strong). Add them up. A total of 3 or higher means high risk. You can find free ACB calculators online or ask a pharmacist.
3. Schedule a medication review with a geriatrician or pharmacist. Bring the list. Ask: “Which of these could be causing confusion or drowsiness?” Don’t be afraid to say, “We’re worried this might be mistaken for dementia.”
4. Don’t quit cold turkey. Some drugs need to be tapered slowly. Work with a professional to reduce or replace them safely. Many side effects improve within weeks.

A 2021 study in the Journal of the American Geriatrics Society found that when seniors had their meds reviewed, falls dropped by 17% and hospital visits dropped by 22%. That’s not just health-it’s independence.

Other Culprits Beyond Anticholinergics

Anticholinergics are the biggest group, but they’re not the only ones:

• Benzodiazepines (like Ativan or Xanax): Cause short-term memory loss in 65% of seniors. Often prescribed for anxiety or sleep, but the risk outweighs the benefit for long-term use.
• Corticosteroids (like prednisone): Can cause mood swings, confusion, and even hallucinations in older adults.
• Opioids (like oxycodone): Lead to memory fog in over half of seniors who take them regularly.

Even something as simple as a cough syrup with diphenhydramine can push someone over the edge. One man in Melbourne started taking it for a cold. Within days, he couldn’t remember his granddaughter’s name. His family thought he was developing Alzheimer’s. The doctor didn’t ask about the cough syrup. Once it was stopped, his memory came back in three weeks.

What’s Changing in 2025?

The tide is turning. The FDA now requires stronger warning labels on 17 high-risk drug classes. Medicare’s Annual Wellness Visit now legally requires a medication review. In Australia, the Pharmaceutical Benefits Scheme (PBS) is expanding pharmacist-led deprescribing programs.

Researchers at Indiana University are testing a blood test that measures acetylcholine levels to spot medication-induced cognitive decline with 89% accuracy. AI tools are being trained to scan electronic health records and flag risky combinations before they’re even prescribed.

But the biggest change isn’t in labs or laws-it’s in awareness. More families are asking the right questions. More pharmacists are speaking up. More doctors are listening.

When to Worry: The Red Flags

Keep an eye out for these signs that point to medication side effects-not aging:

• Sudden confusion or disorientation (not gradual)
• Forgetfulness that comes and goes with medication timing
• Increased drowsiness or slow movements
• New dizziness or falls (risk increases 200% with certain drugs)
• Unexplained weight loss (5+ pounds in a month)
• Dry mouth, constipation, or trouble peeing

If you see these, act fast. Don’t wait for a doctor’s appointment. Call the pharmacist. Ask for a medication review. Bring the list. Be persistent.

Final Thought: It’s Not Normal-It’s Preventable

Aging doesn’t have to mean losing your mind. Many of the symptoms we blame on getting older are actually the result of outdated prescriptions, careless polypharmacy, and a system that doesn’t always check what’s in the medicine cabinet.

The good news? You can fix this. You don’t need expensive tests or complicated treatments. Just a list, a question, and the courage to say: “This doesn’t feel right.”

And sometimes, the most powerful medicine isn’t a pill-it’s the decision to stop one.