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Objective: Previous studies have shown that gabapentin or pregabalin use is associated with cognitive decline. Herein, we aimed to evaluate the association between gabapentin or pregabalin use and the risk of dementia. Methods: In this retrospective, population-based matched cohort stu One study found that long-term administrations of Gabapentin alone did not cause memory loss or memory impairment. Patients can, however, experience brain fog or slight confusion upon taking this medication, but nothing as severe as dementia. Moreover, dementia risk increased along with the cumulative dose. Taking an anticholinergic for the equivalent of three years or more was associated with a 54% higher dementia risk than taking the same dose for three months or less. The University of Washington study is the first to include nonprescription drugs. Gabapentin has been increasingly prescribed to older adults for off-label indications, and accumulating evidence suggests potential for gabapentin misuse and related adverse events. However, the relation between gabapentin initiation and longer-term neurocognitive changes is not well understood. Gabapentin use has been associated with memory loss and cognitive decline. Studies suggest that the risk of dementia may be higher in patients treated with gabapentin. It is important for patients and healthcare providers to be aware of the potential cognitive side effects of gabapentin. The evidence of gabapentin and dementia is mixed, with two studies looking at hundreds of thousands of people and coming to completely different conclusions. Most of the data to guide gabapentin use and dosing in older adults is from pharmacokinetic studies or case reports[1,2] While gabapentin is approved to prevent seizures, most patients take gabapentin for reasons of neuropathic pain (71%) or psychiatric disorders, with bipolar being most common (15%), with an average dose of 975 mg per day Especially in older adults, gabapentin is prescribed to treat behavioral and psychological symptoms of dementia (BPSD) (Kim et al., 2008). Several studies have reported that gabapentin has a deleterious effect on cognition (Leach et al., 1997; Meador et al., 1999; Shem et al., 2018). Studies have shown that gabapentin alone does not cause memory loss or impairment when used for long-term treatment. However, some patients may experience brain fog or slight confusion as potential side effects. The HR (95% CI) of dementia for gabapentin or pregabalin exposure was 1.45 (1.36–1.55) compared to non-exposure group, after adjustment for diabetes mellitus, hypertension, stroke, hyperlipidemia, depression, and head injury. While studies haven’t definitively confirmed gabapentin causes long-term memory loss or impairment as severe as dementia, patients can experience brain fog and slight confusion. However, it is important to acknowledge the existing evidence that links long-term gabapentin use to cognitive decline including memory. The adjusted odds ratio for dementia risk associated with gabapentin use was 0.91 (95 % C.I. 0.83-1.01), indicating no substantial increase in risk. Conclusion: Long-term Gabapentin therapy for chronic pain is not associated with a differential risk of dementia across dosage levels, irrespective of age or gender. Further study into its Gabapentin use was significantly associated with decline in cognitive and functional status among older adults with initially normal cognition. Further studies are needed to examine the association. Applying the inclusion and exclusion criteria yielded 201,492 patients for the study: 25,373 in the dementia cohort and 174,930 in the non-dementia cohort. Post 1:1 matching, and after excluding recent gabapentin use (within three months of the index date), the study comprised 22,769 individuals in the dementia cohort and 22,644 in the non-dementia The multivariate-adjusted hazard ratio of risk of dementia for gabapentin or pregabalin exposure versus the matched non-exposed group was 1.45 (95% confidence interval [CI], 1.36–1.55). The risk of dementia increased with higher cumulative defined daily doses during the follow-up period. Medications that have been associated with increased risk of dementia include overactive bladder medications, pain medications, heartburn medications, and certain anxiety medications. The risk of dementia with these medications increases when you take higher doses over longer periods of time. The study showed that gabapentin use not linked to higher dementia risk. No elevated dementia risk was found across varying dosage levels or among different age and gender subgroups. Since gabapentin is also prescribed to treat behavioral and psychological symptoms of dementia (BPSD) 19, gabapentin could be widely prescribed in patients with dementia. However, a recent paper addressed that there is a possibility of an association between gabapentin and cognitive decline 20 . There’s mounting evidence supporting a connection between certain medications (anticholinergics and benzodiazepines) and dementia. An expert discusses the latest research and what to do if you 3.2 Functional status decline. The same sample was used for assessing functional status change as measuring cognitive decline ().At the first visit after index, the association of gabapentin initiation with functional decline was not significant for either change in FAQ sum (OR [95% CI]: 1.50 [0.76, 2.96]) or FAQ mean (1.56 [0.93, 2.63]).
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