For me, it boils down to this: If you are worried about dementia, so are a lot of us, so, fair -- just like cancer or heart disease or shingles, it's worth deciding what we are willing to do to make it less likely we will get sick. If you are especially worried about dementia and ambien, and you would feel better if you stopped using it, how hard would it be to stop -- what would you do instead? Are there other changes you could make that reduce the risk of dementia? There's a whole suite of behaviors we can work on that have been shown to reduce the risk of dementia, and living your life worried is reason enough to try them.

I have not taken ambien as long as you have, but my husband has been taking it for decades, and he's a sharp guy. If he stopped taking it, his life would be awful, which would not be worth the small chance that he might get dementia earlier than he otherwise would, if he gets dementia at all.

In the interests of having the facts, here are two recent studies of insomnia and drugs that are kind of technical, but useful. This study (https://pubmed.ncbi.nlm.nih.gov/34955792/) found benzodiazepines correlate with cognitive impairment, but found that the z-drugs (including zolpidem, which is ambien) did not. This study (https://pubmed.ncbi.nlm.nih.gov/40108057/) found that both zolpidem and benzodiazepine use correlated with Alzheimers and dementia.

How to make sense of this? First, depending on how you do the analysis and the data you use, ambien may or may not correlate with dementia, so the relationship isn't very strong. Second, this is statistical, meaning that it's going to be true for some people, not true for other people, and no one can tell which is which. Therefore, even if some people who take ambien are more likely to get dementia (or people who get dementia are more likely to have insomnia first, because that's another way to read the data), that might or might not be you or me.

I can say that there are a ton of things that statistically make it more or less likely that we will get dementia, and more studies are being done all the time that find more of them. Some of them are really clear and you can test for, like having the APOE4 gene. Most of them are just playing the odds. There are so many that I've kind of stopped letting them run my life, even though I have a strong family history of dementia, which both my parents had for years. I went through a couple of years of freaking out after my mother died, but now I just casually keep on top of what's going on in that world, in case I run into something useful. I have a family history of colon cancer, too, and make sure I get tested. I care, but I no longer worry all the time -- I'm just kind of past that.

But as I say, I spent a couple of years in that head space, so I get it.