Why Preventive Care Still Matters?
A diagnosis of dementia does not mean other health needs stop. In fact, staying on top of preventive care becomes even more important because:
- Untreated health problems (infections, pain, poor vision, hearing loss) can worsen confusion and behavioral challenges.
- Many conditions like high blood pressure, diabetes, and heart disease still need regular monitoring and can themselves worsen cognitive problems.
- Preventive visits are a chance to catch new problems early, before they become emergencies.
- Preventive care helps maintain the best possible quality of life at every stage of dementia.
Key Preventive Care Visits and Screenings
Annual Wellness Visit (Medicare)
If you have Medicare, they cover a yearly wellness visit that includes a check on memory and thinking, a review of all medications, screening for depression, and updates to the care plan. Bring a caregiver or family member to every visit.
Recommended Ongoing Care
- Blood pressure checks at every visit.
- Blood sugar monitoring (if diabetic).
- Annual flu vaccine, pneumonia and COVID-19 vaccines as recommended.
- Vision and hearing checks, untreated hearing or vision loss can make confusion worse.
- Dental care, mouth pain can cause agitation and poor eating.
- Fall risk assessment, review of home safety, footwear, and balance.
- Screening for depression and sleep problems.
- Skin checks for pressure sores (in later stages).
Recommended Check-In Schedule
Use this as a general guide. The doctor may recommend a different schedule based on individual needs.
| What | How Often |
| Doctor visit for dementia care | Every 3–6 months |
| Cognitive assessment (testing memory and thinking) | At your annual wellness visit or when health changes |
| Functional assessment (daily living abilities) | At your annual wellness visit or when health changes |
| Depression screening | At your annual wellness visit or when health changes |
| Blood pressure, blood sugar, cholesterol check | As recommended by doctor |
| Hearing and vision check | At your annual wellness visit or when health changes |
| Medication review | Every visit |
| Vaccination updates | As recommended |
| Dental check-up | Every 6 months |
| Safety and driving discussion | At your annual wellness visit or when health changes |
| Advance care planning review | At your annual wellness visit or when health changes |
| Caregiver well-being check-in | Every visit |
Setting and Tracking Health Care Goals
Working with the care team to set clear, realistic goals helps everyone stay focused on what matters most. Goals should reflect the patient’s values and wishes and should be revisited regularly.
Examples of Health Care Goals:
- Stay safe and comfortable at home as long as possible.
- Keep blood pressure under control to reduce stroke risk.
- Stay physically active with daily walks.
- Maintain a healthy weight and good nutrition.
- Reduce unnecessary medications and polypharmacy.
How to Track Progress?
Keep a simple notebook or folder with:
- Current medication list (updated at every visit).
- Blood pressure and blood sugar readings.
- Weight (checked monthly).
- Notes on sleep, mood, appetite, and behavior changes.
- Questions for the next doctor visit.
At each visit, review goals with the doctor and adjust as needed. As dementia progresses, goals may shift. For example, from managing chronic diseases aggressively to focusing on comfort and quality of life.
Advance Care Planning
Early in the diagnosis, discuss and document:
- Who will make medical decisions if the patient can no longer do so (health care proxy / power of attorney).
- Preferences about hospitalization, feeding tubes, and resuscitation.
- Where the patient would like to receive care in later stages.
These conversations are easier to have early, while the person with dementia can still participate.
Over the Counter (OTC) Medications
What You Need to Know?
Many common OTC medications can be harmful for people with dementia or interfere with other prescription medications. Always talk to the provider or pharmacist before giving any OTC products.
Talk with your provider before using these OTC Medications
| Medication | Common Brand Names | Why This Needs to be Addressed |
| Diphenhydramine | Benadryl, Tylenol PM, Advil PM, ZzzQuil | Strong anticholinergic, worsens confusion, causes drowsiness, increases fall risk |
| Doxylamine | Unisom SleepTabs, NyQuil | Same risks as diphenhydramine |
| Chlorpheniramine | Chlor-Trimeton | Anticholinergic, worsens thinking and causes sedation |
| Ibuprofen / Naproxen (NSAIDs) | Advil, Motrin, Aleve | Can cause stomach bleeding, kidney problems, and may increase fall risk |
| Loperamide (high doses) | Imodium | Can cause confusion in older adults |
| OTC sleep aids with antihistamines | Various “PM” products | Worsen cognition, increase fall and delirium risk |
Safer Alternatives (Ask Your Doctor First)
- For pain: Acetaminophen (Tylenol) at recommended doses is generally the safest first choice.
- For allergies: Second-generation antihistamines like loratadine (Claritin) or fexofenadine (Allegra) are preferred over diphenhydramine.
- For sleep: Non-drug approaches like consistent bedtime routine, limiting caffeine, daytime activity, and a calm sleep environment are the first-line treatment. If medication is needed, the doctor can recommend a safer option.
- For heartburn: Talk to the doctor before using antacids or acid reducers long-term.
Important Rule: One Medication List
Keep one complete, up-to-date list of ALL medications, prescription, OTC, and supplements. Bring it to every doctor visit and pharmacy trip. This helps prevent dangerous interactions.
Vitamins and Supplements
What the Evidence Says?
Many families wonder whether vitamins or supplements can help slow dementia. Here is what current research shows:
No supplement has been proven to prevent or treat dementia. Despite marketing claims, large studies have not found clear benefits from the following for preventing or slowing cognitive decline: Ginkgo biloba, Omega-3 fatty acids (fish oil), Vitamin E (high doses may carry risks), Vitamin C, Vitamin D, Coconut oil and Multivitamins.
What May Be Worth Discussing with the Doctor?
- Vitamin B12: Deficiency is common in older adults and can cause or worsen confusion. The doctor should check B12 levels. If low, supplementation is important.
- Folate (Vitamin B9): Low folate and high homocysteine levels are associated with higher dementia risk. Supplementation may help if levels are low.
- Vitamin D: Deficiency is common and should be corrected for bone health and fall prevention, even though it has not been shown to improve cognition.
- Multivitamin: This is like an insurance policy to make sure you are getting everything you need from your diet.
Key Points About Supplements
- “Natural” does not mean “safe.” Supplements can interact with prescription medications.
- Supplements are not regulated the same way as prescription drugs, so quality and dosing can vary.
- Never start or stop a supplement without telling the doctor.
- A balanced diet rich in fruits, vegetables, whole grains, fish, and nuts (such as a Mediterranean-style diet) is the best-supported nutritional approach for brain health.
Tips for Caregivers and Family Members:
At Doctor Visits
- Always accompany the person with dementia to appointments.
- Bring the medication list, the tracking notebook, and a written list of questions or concerns.
- Ask the doctor to review all medications at least once a year, some may no longer be needed.
- Ask about each medication: “Is this still necessary? Could it be causing side effects?”
At Home
- Store all medications (including OTC products) in a locked or supervised location.
- Use a pill organizer or medication management system.
- Do not let the person with dementia self-medicate with OTC products.
- Watch for signs of medication side effects: increased confusion, drowsiness, dizziness, falls, or stomach upset.
Bottom Line:
- Preventive care helps maintain quality of life, it does not stop after a dementia diagnosis.
- Set personal, meaningful health goals together as a team and revisit them regularly.
- Prepare for every doctor visit with notes on what has changed and what matters most.
- Plan ahead with advance directives and a health care proxy.
- Caregiver health is just as important, seek support early and often.
References:
Beers Criteria for inappropriate medications use in older adults: Update from the American Geriatric Society.
American Family Physician. 2024. Arnold MJ.
Medication misuse and overuse in community-dwelling persons with dementia.
Journal of the American Geriatrics Society. 2023. Deardorff WJ, Jing B, Growdon ME, et al.
Dementia prevention and treatment: A narrative review.
JAMA Internal Medicine. 2024. Reuben DB, Kremen S, Maust DT.
