Common back-pain drug may be linked to higher dementia risk, large study finds

An Important Clarification About Mobility
One factor the researchers were particularly mindful of was the role of physical mobility. It is already well established in medical literature that limited mobility and a sedentary lifestyle can increase a person’s risk of cognitive decline. Since many people taking gabapentin for back pain may also have limited mobility due to their condition, one might assume that reduced physical activity — rather than the medication itself — could explain the cognitive findings.

The researchers addressed this directly by ensuring that the comparison group also consisted of individuals with similarly restricted mobility due to their back pain. Despite this careful matching, gabapentin users still showed significantly higher rates of cognitive decline — suggesting that mobility limitations alone do not account for the difference.

What Patients and Caregivers Should Know
Nerve pain drug gabapentin linked to increased dementia, cognitive impairment risks

The most important message from this research is not one of alarm, but of awareness. Gabapentin continues to be approved for use and is considered appropriate for many patients when prescribed and monitored correctly. Abruptly stopping the medication without medical guidance is not advisable and can cause withdrawal symptoms.

However, the study does reinforce several recommendations that experts say are worth taking seriously:

Talk to your doctor. If you or someone you care for has been on gabapentin for an extended period — particularly with six or more prescriptions — it may be worth having a conversation with your healthcare provider about the latest research and whether the current treatment plan remains the most appropriate one.

Consider cognitive check-ins. Particularly for middle-aged adults on long-term gabapentin therapy, proactive monitoring of cognitive health could allow for earlier detection of any changes in memory or thinking.

Explore alternatives. For patients whose conditions allow it, discussing alternative approaches to pain management — whether physical therapy, other medications, or lifestyle changes — may be worth exploring in light of these findings.

Avoid unnecessary long-term use. Where clinically appropriate, healthcare providers may want to reassess whether continued long-term gabapentin use is necessary for each individual patient.