Patrick Imfeld1,2, Michael Bodmer1, Susan S Jick3, Christoph R Meier4,5,6. 1. Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland. 2. Hospital Pharmacy, University Hospital Basel, Basel, Switzerland. 3. Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, MA, USA. 4. Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland. christoph.meier@usb.ch. 5. Hospital Pharmacy, University Hospital Basel, Basel, Switzerland. christoph.meier@usb.ch. 6. Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, MA, USA. christoph.meier@usb.ch.
Abstract
INTRODUCTION: Previous observational studies have associated benzodiazepine use with an increased risk of dementia. However, limitations in the study methods leave questions unanswered regarding the interpretation of the findings. METHODS: A case-control analysis was conducted using data from the UK-based Clinical Practice Research Datalink (CPRD). A total of 26,459 patients aged ≥65 years with newly diagnosed Alzheimer's disease (AD) or vascular dementia (VaD) between 1998 and 2013 were identified and matched 1:1 to dementia-free controls on age, sex, calendar time, general practice, and number of years of recorded history. Adjusted odds ratios (aORs) were calculated with 95% confidence intervals (CIs) of developing AD or VaD in relation to previous benzodiazepine use, stratified by duration and benzodiazepine type. RESULTS: The aOR (95% CI) of developing AD for those who started benzodiazepines <1 year before diagnosis was 2.20 (1.91-2.53), and fell to the null for those who started between 2 and <3 years before [aOR 0.99 (0.84-1.17)]. The aOR (95% CI) of developing VaD for those who started benzodiazepines <1 year before diagnosis was 3.30 (2.78-3.92), and fell close to the null for those who started between 3 and <4 years before [aOR 1.16 (0.96-1.40)]. After accounting for benzodiazepine use initiated during this prodromal phase, long-term use of benzodiazepines was not associated with an increased risk of developing AD [aOR 0.69 (0.57-0.85)] or VaD [aOR 1.11 (0.85-1.45)]. CONCLUSION: After taking a prodromal phase into consideration, benzodiazepine use was not associated with an increased risk of developing AD or VaD.
INTRODUCTION: Previous observational studies have associated benzodiazepine use with an increased risk of dementia. However, limitations in the study methods leave questions unanswered regarding the interpretation of the findings. METHODS: A case-control analysis was conducted using data from the UK-based Clinical Practice Research Datalink (CPRD). A total of 26,459 patients aged ≥65 years with newly diagnosed Alzheimer's disease (AD) or vascular dementia (VaD) between 1998 and 2013 were identified and matched 1:1 to dementia-free controls on age, sex, calendar time, general practice, and number of years of recorded history. Adjusted odds ratios (aORs) were calculated with 95% confidence intervals (CIs) of developing AD or VaD in relation to previous benzodiazepine use, stratified by duration and benzodiazepine type. RESULTS: The aOR (95% CI) of developing AD for those who started benzodiazepines <1 year before diagnosis was 2.20 (1.91-2.53), and fell to the null for those who started between 2 and <3 years before [aOR 0.99 (0.84-1.17)]. The aOR (95% CI) of developing VaD for those who started benzodiazepines <1 year before diagnosis was 3.30 (2.78-3.92), and fell close to the null for those who started between 3 and <4 years before [aOR 1.16 (0.96-1.40)]. After accounting for benzodiazepine use initiated during this prodromal phase, long-term use of benzodiazepines was not associated with an increased risk of developing AD [aOR 0.69 (0.57-0.85)] or VaD [aOR 1.11 (0.85-1.45)]. CONCLUSION: After taking a prodromal phase into consideration, benzodiazepine use was not associated with an increased risk of developing AD or VaD.
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