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Anticholinergic side effects
(e.g., from antipsychotics, antidepressants, diphenhydramine) are
problematic in individuals with dementia and can also exacerbate
coexisting cardiovascular disease, prostate or bladder disease,
or other general medical conditions. Anticholinergic medications
may also lead to worsening cognitive impairment, confusion, or even
Elderly patients, especially if suffering from dementia,
are more prone to falls and associated injuries because of orthostasis.
Medications associated with central nervous system (CNS)
sedation (e.g., benzodiazepines) may worsen cognition, increase
the risk of falls, and put patients with sleep apnea at risk of
additional respiratory depression.
Use of antipsychotics may be associated with worsening
cognitive impairment, oversedation, falls, tardive dyskinesia, and
neuroleptic malignant syndrome, as well as with hyperlipidemia,
weight gain, diabetes mellitus, cerebrovascular accidents, and death.
The elderly, particularly those with Parkinson's disease
or dementia with Lewy bodies, are especially sensitive to extrapyramidal