Benzodiazepines Tied to Dementia in Elders — Physician’s First Watch

Medical News |
September 28, 2012

Benzodiazepines Tied to Dementia in Elders

Benzodiazepine drugs are associated with increased risk for dementia, according to a BMJ study.

The study included nearly 1100 community-dwelling, older adults in France who were free of dementia; 9% were considered new users of benzodiazepines — that is, they began using the drugs after the third year of follow-up.

During the next 15 years, dementia was diagnosed significantly more often in new benzodiazepine users than in nonusers (32% vs. 23%). After adjustment for confounders such as age, diabetes, and depression, new users had a 60% increased risk for dementia. A complementary, nested case-control analysis found a similar increase in risk.

The researchers argue against the idea that benzodiazepine use is simply a marker for other conditions (e.g., anxiety) that are linked to dementia — for example, the association between the drugs and dementia increased after 7 years of use. However, they acknowledge that such a theory cannot be "entirely ruled out."

Reader Comments (3)

J Ross Hester, AcCH Other Healthcare Professional, Psychiatry, Edcom Associates Holistic Health

While insomnia and other disturbances of sleep architecture, are also associated with increased risk of mortality and dementia, combining these drug classes should be questioned in light of other less invasive therapeutic options like CBT, hypnosis, and biofeedback.

ROBERT BARKER Physician, Gastroenterology, Retired

My experience would suggest that benzodiazepines exacerbate rather than cause dementia, and should not be given to elderly people. The distress caused by being disoriented is not ameliorated by giving medications that impair one's cognitive abilities.

David L Evans, RN, ANP

The putative 50% increase in dementia among benzo users in this study is very misleading. Although one could read the statistics that way (even that is doubtful), the authors basically conclude, if you look closely, that 1.2 non-users of benzos per 100 patients (all lumped together with some non-benzos) will be diagnosed with dementia during the long study, while benzo users at any time and at any dose will have 1.8/100 patients diagnosed as such. The authors thus substract 1.2 from 1.8 and then divide 0.6 into 1.2, getting 50%. This is grossly misleading. The true absolute risk would less than 1% (0.6 user per every 100 patients). Telling an indivudal he has less than a 1% absolute risk of developing dementia for any given time period means something very different than just saying you have a 50% chance of being demented if you use any benzos at any time. The article poorly defines and tests for dementia (using 3 tests but not indicating what scores were used and how) and omits controlling for some of the most common reasons benzos get prescribed to elders (sleep disorders that are bothering caretakers because the patient is already showing signs of dementia, anxiety symptoms that are hard to control, and so forth). This is an important subject, but this article does not settle the issue by any means.

Competing interests: None declared

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