Willy Gomm1, Klaus von Holt1, Friederike Thomé1, Karl Broich2, Wolfgang Maier1,3, Klaus Weckbecker4, Anne Fink1,5, Gabriele Doblhammer1,5,6,7, Britta Haenisch1. 1. German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany. 2. Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany. 3. Department of Psychiatry, University of Bonn, Bonn, Germany. 4. Department of General Practice and Family Medicine, University of Bonn, Bonn, Germany. 5. Rostock Center for the Study of Demographic Change, Rostock, Germany. 6. Max-Planck-Institute for Demographic Research, Rostock, Germany. 7. Institute for Sociology and Demography, University of Rostock, Rostock, Germany.
Abstract
BACKGROUND: While acute detrimental effects of benzodiazepine (BDZ), and BDZ and related z-substance (BDZR) use on cognition and memory are known, the association of BDZR use and risk of dementia in the elderly is controversially discussed. Previous studies on cohort or claims data mostly show an increased risk for dementia with the use of BDZs or BDZRs. For Germany, analyses on large population-based data sets are missing. OBJECTIVE: To evaluate the association between regular BDZR use and incident any dementia in a large German claims data set. METHODS: Using longitudinal German public health insurance data from 2004 to 2011 we analyzed the association between regular BDZR use (versus no BDZR use) and incident dementia in a case-control design. We examined patient samples aged≥60 years that were free of dementia at baseline. To address potential protopathic bias we introduced a lag time between BDZR prescription and dementia diagnosis. Odds ratios were calculated applying conditional logistic regression, adjusted for potential confounding factors such as comorbidities and polypharmacy. RESULTS: The regular use of BDZRs was associated with a significant increased risk of incident dementia for patients aged≥60 years (adjusted odds ratio [OR] 1.21, 95% confidence interval [CI] 1.13-1.29). The association was slightly stronger for long-acting substances than for short-acting ones. A trend for increased risk for dementia with higher exposure was observed. CONCLUSION: The restricted use of BDZRs may contribute to dementia prevention in the elderly.
BACKGROUND: While acute detrimental effects of benzodiazepine (BDZ), and BDZ and related z-substance (BDZR) use on cognition and memory are known, the association of BDZR use and risk of dementia in the elderly is controversially discussed. Previous studies on cohort or claims data mostly show an increased risk for dementia with the use of BDZs or BDZRs. For Germany, analyses on large population-based data sets are missing. OBJECTIVE: To evaluate the association between regular BDZR use and incident any dementia in a large German claims data set. METHODS: Using longitudinal German public health insurance data from 2004 to 2011 we analyzed the association between regular BDZR use (versus no BDZR use) and incident dementia in a case-control design. We examined patient samples aged≥60 years that were free of dementia at baseline. To address potential protopathic bias we introduced a lag time between BDZR prescription and dementia diagnosis. Odds ratios were calculated applying conditional logistic regression, adjusted for potential confounding factors such as comorbidities and polypharmacy. RESULTS: The regular use of BDZRs was associated with a significant increased risk of incident dementia for patients aged≥60 years (adjusted odds ratio [OR] 1.21, 95% confidence interval [CI] 1.13-1.29). The association was slightly stronger for long-acting substances than for short-acting ones. A trend for increased risk for dementia with higher exposure was observed. CONCLUSION: The restricted use of BDZRs may contribute to dementia prevention in the elderly.
Authors: Taylor J Krivanek; Seth A Gale; Brittany M McFeeley; Casey M Nicastri; Kirk R Daffner Journal: J Alzheimers Dis Date: 2021 Impact factor: 4.472
Authors: Carlota M Grossi; Kathryn Richardson; Chris Fox; Ian Maidment; Nicholas Steel; Yoon K Loke; Antony Arthur; Phyo Kyaw Myint; Noll Campbell; Malaz Boustani; Louise Robinson; Carol Brayne; Fiona E Matthews; George M Savva Journal: BMC Geriatr Date: 2019-10-21 Impact factor: 3.921