I m not sure what you consider long term. I m in my 60s and have been taking APs steadily since my 20s. I started when I was 18. From 22 until 28 I guess I was off them and from then on have never been off them again. So I have taken both old and new generation APs. I don't have dementia or memory problems. And I am not at death's door either. I don't know how much longer I will live but it doesn't seem as though I will have an early death due to bipolar. So I don't believe APs cause dementia. In addition I take benzodiazepines and suffer no ill effects from them either. So sometimes the meds aren't so bad. I have had very bad effects from the ones I can't take but on the right cocktail of meds I seem to be doing ok. So don't let the fear of meds ruin what could possibly work. For me too it is a choice of taking meds or going in and out of the hospital. I much prefer the meds.