July 2026 Dementia in Men

July topic of the month: 

Factors contributing to dementia in men, with a special focus on PTSD 

Dementia in males: 

Although the cause of dementia is multifactorial for both genders, it is important that we emphasize the risk factors that may be more prominent for one gender than the other. This may assist individuals of a certain gender to recognize prominent risk factors in their lifestyles. 

This month we want to focus on the male population and their unique challenges. 

According to the Mayo clinic we should focus on risk factors that can’t be changed vs. risk factors that can be changed: 

Risk factors that can't be changed 

Being aware of these risk factors can help you understand your dementia risk. 

• Age. The risk of dementia rises as you age, especially after age 65. However, dementia isn't a typical part of aging. Dementia can also occur in younger people. 

• Family history. Having a family history of dementia puts you at greater risk of developing the condition. However, many people with family history never develop symptoms, and many people without a family history do. There are tests to determine whether you have certain genetic changes that may increase your risk. 

• Down syndrome. By middle age, many people with Down syndrome develop early-onset Alzheimer's disease. 

Risk factors you can change 

You might be able to manage the following risk factors for dementia. 

• Lifestyle factors. Research has found that people at higher risk of dementia who followed a healthy lifestyle lowered their risk of cognitive decline. They ate a diet that included fish, fruits, vegetables, and olive oil. They also exercised, had cognitive training, and participated in social activities. While no specific diet is known to reduce dementia risk, research indicates that those who follow a Mediterranean style diet have better cognitive function. A Mediterranean diet focuses on fruits, vegetables, cereals, olive oil, nuts, and fish. The diet includes smaller amounts of dairy and meat. 

• Drinking too much alcohol. Drinking large amounts of alcohol has long been known to cause brain changes. Several large studies and reviews have linked alcohol use disorders with an increased risk of dementia, particularly early-onset dementia. 

• Hormonal changes such as Low Testosterone: Some studies suggest that lower levels of testosterone in older men may correlate with cognitive decline and an increased risk of dementia 

• Cardiovascular risk factors. These include obesity, high blood pressure, high cholesterol, and the buildup of fats in the artery walls, known as atherosclerosis. Having high levels of low-density lipoprotein (LDL), in particular, is a risk factor for cognitive decline and dementia. Diabetes and smoking also are cardiovascular risk factors. Having diabetes can increase the risk of dementia, especially if blood sugar isn't managed well. Smoking might increase the risk of developing dementia and blood vessel disease. 

• Hearing loss or vision loss that is not treated. Having hearing loss is associated with a higher risk of dementia. The worse the hearing loss, the higher the risk. Research also suggests that vision loss can raise the risk of dementia, while treating vision loss can lower the risk. 

• Mental Health & Social Habits: Untreated depression, chronic stress, and social isolation are recognized by major health organizations as important contributors to cognitive decline. 

• Air pollution. Studies in animals have indicated that air pollution particulates can speed degeneration of the nervous system. And human studies have found that air pollution exposure — particularly from traffic exhaust and burning wood — is associated with greater dementia risk. 

• Head trauma. People who've had severe head trauma have a greater risk of Alzheimer's disease. Several large studies found that the risk of dementia and Alzheimer's disease increased in people age 50 years or older who had a traumatic brain injury, also called TBI. The risk is higher in people with more, severe, and multiple TBIs. 

• Sleep conditions. People who have sleep apnea and other sleep disturbances might be at higher risk of getting dementia. 

• Low levels of certain vitamins and nutrients. Low levels of vitamin D, vitamin B-6, vitamin B-12 and folate can increase the risk of dementia. 

• Medicines that can worsen memory. These include sleep aids or allergy medicines that contain diphenhydramine (Benadryl, Unisom, others). They also include medicines you can get with or without a prescription to treat urinary urgency, such as oxybutynin (Oxytrol). Sedatives should be limited as well. Talk with a healthcare professional about whether any of the medicines you take might make your memory worse. 

10 Medications That Can Worsen Dementia Symptoms 

• Certain medications can worsen cognitive decline in people with dementia or increase the risk of developing dementia, especially in older adults. These effects are often linked to how the drug impacts brain chemistry, such as blocking acetylcholine or over-sedating the central nervous system. Always consult a healthcare provider before stopping or changing any medication. 

1. Anticholinergic drugs 
   These block acetylcholine, a neurotransmitter essential for memory and learning. Examples include: 

• Diphenhydramine (Benadryl, Advil PM, Tylenol PM) 

• Chlorpheniramine (Chlor-tab, Aller-Chlor) 

• Doxylamine (Unisom) 

• Oxybutynin (anticholinergic bladder medication) 

• Tricyclic antidepressants (e.g., amitriptyline, nortriptyline)  

2. Benzodiazepines 
   Long-term use (especially >6 months) is linked to up to an 84% higher dementia risk. Examples: 

• Diazepam (Valium) 

• Alprazolam (Xanax) 

• Lorazepam (Ativan) 

3. Antipsychotics 
   Used in dementia for behavioral issues but carry a high fatality risk. Examples: 

• Olanzapine (Zyprexa) 

• Risperidone (Risperdal) 

• Quetiapine (Seroquel)  

4. Corticosteroids 
   Long-term or high-dose use can impair cognition. Examples: 

• Prednisone 

• Dexamethasone  

5. Beta-blockers 
   Some studies link long-term use to higher dementia risk, especially in older adults. Examples: 

• Metoprolol 

• Atenolol  

6. Opioids 
   Chronic use can contribute to cognitive decline. Examples: 

• Oxycodone 

• Hydrocodone  

7. Proton-pump inhibitors (PPIs) 
   Long-term use may increase dementia risk, possibly via vitamin B12 deficiency or other mechanisms. Examples: 

• Omeprazole 

• Esomeprazole  

8. Certain SSRIs 
   While some SSRIs may reduce dementia risk, others (e.g., citalopram, escitalopram) can cause sedation or confusion in dementia patients optoceutics.com. 
9. Antihistamines (first-generation) 
   Strong anticholinergics like diphenhydramine and doxylamine can worsen memory and confusion  
10. Some bladder medications 
    Oxybutynin and other anticholinergics that cross the blood-brain barrier can impair cognition 

Post Traumatic Stress Disorder is directly linked to increased dementia risk in male Veterans: 

Post-traumatic stress disorder (PTSD) is a common mental health problem with long-term health consequences. PTSD has a known etiological agent, experiencing an event that involves life threat, serious injury, or risk of death in early or late life  

• PTSD is well studied in male veterans but not in females 

• When PTSD is associated with depression an individual is at a twofold risk for developing dementia 

• 3%-6% of older adults struggle with PTSD 

• Older male veterans with prior PTSD are two to four times as likely to develop dementia 

• There is a higher incident of chronic illnesses when PTSD is present 

• 70% of older adults with PTSD have dementia 

• Traumatic Head Injury with PTSD will increase risk for dementia 

• Several recent studies have found that adults with PTSD were two to three times more likely to have comorbid psychiatric disorders, including major depression, mood disorders, anxiety disorders, and drug abuse/dependence  

https://pmc.ncbi.nlm.nih.gov/articles/PMC5729063/ 

In Summary: 

A male veteran with a history of PTSD, depression, smoking, regular alcohol consumption and a sedentary lifestyle, combined with chronic disease is at a severe risk for developing dementia. 

The Good News: 

You can decrease your risk even if you suffer from PTSD and depression: 

• Test and manage hormone levels 

• Manage stress daily 

• Limit or eliminate smoking and alcohol consumption 

• Maintain a healthy social life 

• Add 30 minutes of daily exercise 

• Get sun and exposure to nature every day 

• Maintain a healthy diet 

• Join support groups and/or engage with a trained counselor 

• Engage in a hobby that brings you joy! 

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