Posted by Phillipa on February 4, 2016, at 10:32:28
In reply to Re: Benzodiazepines: No Dementia Risk?, posted by Phillipa on February 4, 2016, at 10:28:37
A TSDD of 1 to 30 represented minimal use for up to 1 month; a TSDD of 31 to 120 represented moderate use of 1 to 4 months; a TSDD of at least 121 represented the highest and longest level of exposure.Overall, 30% of participants had filled at least one prescription for benzodiazepines in the 10 years before study entry. The most commonly used benzodiazepines were temazepam (multiple brands), diazepam (multiple brands), clonazepam (Klonapin, Roche), triazolam (Halcion, Pharmacia and Upjohn), and lorazepam (multiple brands).
During a mean of 7.3 years of follow-up, 23.2% of participants developed incident dementia; 79.9% of those cases were associated with Alzheimer's disease (AD).
There was no association between the highest level of benzodiazepine use (121 or more TSSDs) and dementia (hazard ratio [HR], 1.07; 95% confidence interval [CI], 0.83 - 1.37) or AD (HR, 0.95; 95% CI, 0.71 - 1.27) compared with nonuse.
Compared with patients who did not use benzodiazepines, there was a slightly increased risk for dementia for those with a low level of use (1 - 30 TSDDs) (HR, 1.25; 95% CI, 1.03 - 1.51) and for those who used benzodiazepines moderately (31 - 120 TSDDs) (HR, 1.31; 95% CI, 1.00 - 1.71).
For patients with AD, the increased risk was found only among those with low use.
"We were expecting to find a higher risk only in those individuals that had high use of benzodiazepines. So contrary to our expectations, we did find the small increased risk for dementia in people with low or moderate use.
"This increase probably reflects treatment of early symptoms of cognitive decline, before an actual diagnosis of dementia," said Dr Gray.
"Before being diagnosed with dementia, patients might have a period of time when they have symptoms such as anxiety, insomnia, or depression, and benzodiazepines are often used to treat those symptoms," she explained. "So the use of benzodiazepines is a consequence of the dementia, not the cause."
The investigators were unable determine the impact of the use of individual benzodiazepines on dementia risk.
The results differ from other studies, some of which have shown a link between benzodiazepine use and dementia risk. This new study is the first to use computerized pharmacy data to examine benzodiazepine use over a long period (10 years), said Dr Gray.
Another difference is in how dementia cases were determined. Previous research used administrative data to identify dementia cases.
"The problem with using administrative data is that there may be a lag in terms of when dementia is actually detected by healthcare providers," said Dr Gray.
A strength of this study is that it followed patients every 2 years to detect dementia early on.
poster:Phillipa
thread:1085929
URL: http://www.dr-bob.org/babble/20160131/msgs/1085931.html