Benzodiazepine Use Might Raise Risk for Alzheimer Disease.

[Argirios Argiriou]

October 21, 2014
Paul S. Mueller, MD, MPH, FACP reviewing Billioti de Gage S et al. BMJ 2014 Sep 9.

In a case-control study, any use of these drugs from 5 to 10 years before AD diagnosis was associated with higher risk.

Some evidence suggests that benzodiazepine use is associated with excess risk for dementia; however, benzodiazepines sometimes are prescribed for prodromes of dementia (e.g., anxiety, insomnia). In this case-control study, investigators examined the association between exposure to benzodiazepines and risk for developing Alzheimer disease (AD).

Cases were 1800 randomly selected older community dwellers (age, >66) in Quebec who had received first diagnoses of AD and had been followed for at least 6 years before their AD diagnoses. Controls were 7200 similar residents who were matched to cases by age, sex, and duration of follow-up. To minimize reverse causality, only benzodiazepine exposure that occurred ≥5 years before diagnosis of AD was considered. After adjustment for multiple variables (including anxiety, depression, and insomnia), any benzodiazepine use (compared with nonuse) was associated with excess risk for AD (odds ratio, 1.5). Cumulative exposure to 1 to 90 prescribed daily doses (PDDs) of benzodiazepines was not associated with excess risk, but exposure to 91 to 180 PDDs (OR, 1.3) and >180 PDDs (OR, 1.7) were. The association was stronger for long-acting benzodiazepines (OR, 1.6) than for short-acting benzodiazepines (OR, 1.4).

Comment

Researchers carefully controlled for reverse causality and potential confounders and found that benzodiazepine use was associated with excess risk for AD. The authors note that chronic benzodiazepine use induces a downregulation of binding receptors and that a reduction in the number of these receptors is correlated with cognitive decline.


Citation(s):

    Billioti de Gage S et al. Benzodiazepine use and risk of Alzheimer's disease: Case-control study. BMJ 2014 Sep 9; 349:g5205. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος)

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