The stock market crash of 1929 wasn't unpredictable to some observers of economic trends and risks, but it took most of the country by surprise when the market lost 25% of its value over October 19 and 20, 1929, and another 25% over the next several weeks.

It’s just an unfortunate part of human nature to avoid disturbing alerts.

These days, it appears that 85% of electronic health record alerts to providers and 95% of alerts to medical assistants that tell them a patient is prescribed a high-risk anticholinergic medication and suggest alternatives go unread and unheeded.

That's what researchers found when they investigated whether or not anyone was paying attention to notifications that older patients were being prescribed specific medications that block acetylcholine, a neurotransmitter that influences memory, alertness, and planning skills. Such blockage could lead to dementia.  

Every year, one in four older adults gets a prescription for these medications to ease depression, urinary incontinence, irritable bowel syndrome, allergies, sleep issues, GERD, and Parkinson's disease. In some cases, they should be de-prescribed (you don't want to stop abruptly — that may trigger its own health hazards) and alternatives should be found. 

Because alerts are so often ignored, the burden falls on the shoulders of older patients and caregivers to ask each doctor if any prescribed medication — or any over-the-counter ones being used — are anticholinergic, and if alternatives are available.

You can look for a list of anticholinergic medications or medications that affect dementia at health.clevelandclinic.org.