Ibuprofen (aka Advil) is a common choice for addressing occasional aches and pains. Individuals with chronic pain may need to take ibuprofen more consistently, especially if their discomfort interrupts sleep. According to the Sleep Foundation, chronic pain can negatively impact sleep, leading to a reduction in overall rest. Insufficient sleep may heighten pain sensitivity, prompting more frequent use of ibuprofen.
Advil offers various formulations, including Advil PM, which is designed to aid sleep while managing pain. It contains 200 milligrams of ibuprofen to inhibit enzymes responsible for pain and inflammation. The other active ingredient in Advil PM is diphenhydramine, an antihistamine known for its sedative effects, which is why it’s also found in some over-the-counter sleep aids.
Diphenhydramine is classified as an anticholinergic drug, meaning it obstructs acetylcholine, a brain chemical linked to learning and memory. Certain antidepressants, bladder control medications, and treatments for Parkinson’s symptoms are also anticholinergic. While occasional use of Advil PM may alleviate pain during sleep, prolonged use of anticholinergic drugs has been associated with an increased dementia risk.
Why Advil PM may affect dementia risk in older adults
Diphenhydramine, an antihistamine, is also present in Benadryl. Whether used as Advil PM for nighttime pain or Benadryl for allergies, diphenhydramine and other first-generation antihistamines can cross the blood-brain barrier. Over time, these substances may impact cognitive function. A 2024 study in The Journal of Allergy and Clinical Immunology: In Practice observed over 700,000 individuals with allergic rhinitis, some of whom took first-generation antihistamines like diphenhydramine. Those consuming the most antihistamines exhibited a 50% higher risk of developing dementia compared to those who did not use them for allergies.
(Here are some warning signs of Alzheimer’s you shouldn’t ignore.)
If you’re younger, the acetylcholine-blocking effects of these drugs may not be noticeable. However, as you age, your body naturally produces less acetylcholine, as noted by Harvard Medical School. Anticholinergic drugs like Advil PM can further reduce these already diminished levels, potentially having a more significant impact on your brain. Furthermore, medications tend to remain in the bloodstream longer in older adults due to slower drug processing by the liver and kidneys.
How some prescription drugs affect the risk of dementia
Advil PM and Benadryl are available over the counter, making it crucial to consult your doctor about using these or any supplements, particularly if you are also on prescription anticholinergic medications. A smaller study published in 2019 in JAMA Internal Medicine specifically examined prescription anticholinergic drugs. Individuals taking the highest doses had nearly a 50% higher risk of developing dementia compared to those not prescribed these medications. The risk was even more pronounced for individuals using these drugs to treat schizophrenia, bladder problems, and Parkinson’s disease.
(Find out about a tool that can predict your dementia risk.)
Anticholinergic drugs may not be the only ones linked to dementia risk. A 2024 review in the International Journal of Molecular Sciences indicated that long-term use of benzodiazepines, such as Xanax and Valium, is also associated with a higher dementia risk. Consequently, benzodiazepines are not recommended for older adults. Acetaminophen and high doses of opioids could also increase dementia risk. Conversely, certain statins capable of crossing the blood-brain barrier might offer brain protection against dementia, although there isn’t sufficient evidence to recommend statins specifically for dementia prevention.
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