Miguel Germán Borda1,2,3, Alberto Jaramillo-Jimenez1,3,4, Ragnhild Oesterhus1,5, Jose Manuel Santacruz2,6,7, Diego Alejandro Tovar-Rios1,8,9, Hogne Soennesyn1, Carlos Alberto Cano-Gutierrez2,10, Audun Osland Vik-Mo1,5, Dag Aarsland1,11. 1. Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway. 2. Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia. 3. Faculty of Health Sciences, University of Stavanger, Stavanger, Norway. 4. Grupo de Neurociencias de Antioquia, Medical School, Universidad de Antioquia, Medellin, Colombia. 5. Department of Clinical Medicine, University of Bergen, Bergen, Norway. 6. Cognition and Memory Center, Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia. 7. Psychiatry Department, Hospital Universitario San Ignacio, Bogotá, Colombia. 8. School of Statistics, Faculty of Engineering, Universidad Del Valle, Santiago de Cali, Colombia. 9. Department of Mathematics and Statistics, Faculty of Basic Sciences, Universidad Autónoma de Occidente, Santiago de Cali, Colombia. 10. Geriatric Unit, Hospital Universitario San Ignacio, Bogotá, Colombia. 11. Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
Abstract
OBJECTIVES: We aim to study the effects of the prescription of benzodiazepines and antidepressants on cognitive and functional decline in older adults living with Alzheimer's disease (AD) and Lewy body dementia (LBD) over a 5-year follow-up. METHODS: This is a longitudinal analysis of a Norwegian cohort study entitled "The Dementia Study of Western Norway" (DemVest). We included 196 patients newly diagnosed with AD (n = 111) and LBD (n = 85), followed annually for 5 years. Three prescription groups were defined: only benzodiazepines (BZD), only antidepressants (ADep), and the combination of benzodiazepines and antidepressants (BZD-ADep). Linear mixed-effects models were conducted to analyze the effect of the defined groups on the outcomes. The outcomes were functional decline, measured by the Rapid Disability Rating Scale-2, and cognition measured with the Mini-Mental State Examination. RESULTS: Prescription of the combination of benzodiazepines and antidepressants in LBD was associated with faster functional decline. In AD, the prescription of BZD and BZD-ADep was associated with greater functional deterioration. ADep alone did not show positive or negative significant associations with the studied outcomes. CONCLUSIONS: BZD and especially the combination of BZD and ADep are associated with functional decline in AD and LBD and should be used cautiously.
OBJECTIVES: We aim to study the effects of the prescription of benzodiazepines and antidepressants on cognitive and functional decline in older adults living with Alzheimer's disease (AD) and Lewy body dementia (LBD) over a 5-year follow-up. METHODS: This is a longitudinal analysis of a Norwegian cohort study entitled "The Dementia Study of Western Norway" (DemVest). We included 196 patients newly diagnosed with AD (n = 111) and LBD (n = 85), followed annually for 5 years. Three prescription groups were defined: only benzodiazepines (BZD), only antidepressants (ADep), and the combination of benzodiazepines and antidepressants (BZD-ADep). Linear mixed-effects models were conducted to analyze the effect of the defined groups on the outcomes. The outcomes were functional decline, measured by the Rapid Disability Rating Scale-2, and cognition measured with the Mini-Mental State Examination. RESULTS: Prescription of the combination of benzodiazepines and antidepressants in LBD was associated with faster functional decline. In AD, the prescription of BZD and BZD-ADep was associated with greater functional deterioration. ADep alone did not show positive or negative significant associations with the studied outcomes. CONCLUSIONS:BZD and especially the combination of BZD and ADep are associated with functional decline in AD and LBD and should be used cautiously.
Authors: Marie H Gedde; Bettina S Husebo; Janne Mannseth; Mala Naik; Geir Selbaek; Maarja Vislapuu; Line Iden Berge Journal: BMC Med Date: 2022-05-26 Impact factor: 11.150