In contrast to the results of an earlier study, a new research states the use of benzodiazepines – medicines commonly used to treat anxiety and insomnia – does not increase the risk of dementia among elderly people.
Study co-author Shelly Gray, and colleagues presented their results in The BMJ.
Benzodiazepines are a category of drugs that increase the level of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain, generating sedative, anticonvulsant, anti-anxiety, hypnotic and muscle relaxant outcomes.
Benzodiazepines are very frequently used to deal with anxiety and insomnia, although they are used for a variety of other problems, such as alcohol withdrawal, panic disorders, and seizures. Common kinds of benzodiazepines include diazepam, alprazolam, and flurazepam.
In the US, benzodiazepine use is maximum among elderly people; a 2014 research from the National Institutes of Health (NIH) identified that about 8.7 percent of people aged 65-80 obtained a benzodiazepine prescription in 2008, in comparison with 2.6 percent of those aged 18-35.
Several studies, however, have connected benzodiazepine use in seniors with enhanced risk of dementia. A 2012 research reported elderly people aged 65 and older are 50 percent more probably to develop dementia inside 15 years of using benzodiazepines while a more latest study recommended benzodiazepine use for at least 3 months raises older adults’ threat of Alzheimer’s condition by 51 percent.
However, Gray and colleagues note that study evaluating benzodiazepine use in elderly people has been conflicting, with some research finding no connection with dementia.
“Given the huge public health implications, we require a better understanding of the possible cognitive risks of cumulative benzodiazepine use,” say the authors.
No dementia link but elderly people should still stay away from benzodiazepines.
With this in thoughts, the research team starts to identify whether the greater cumulative use of benzodiazepines among elderly people is connected with an enhanced risk of dementia or quicker cognitive decline.
To do so, the investigators examined the data of 3,434 adults aged 65 and older who were part of the Adult Changes in Thought study, carried out within Group Health – a non-profit health care system in Seattle, WA.
All individuals were free of dementia at research baseline, and cognitive screening was performed at enrollment and every 2 years afterward. Participants were followed-up for an average of 7 years.
Pharmacy data from Group Health was examined to evaluate subjects’ regular use of benzodiazepines over a decade period.
While in follow-up, 797 of the subjects developed dementia. Of these, 637 developed Alzheimer’s disease. The median level of benzodiazepine use among individuals was the equivalent to 1 year of daily use.
The investigators identified that participants with the highest benzodiazepine use were at no greater risk for dementia or Alzheimer’s than those with reduced benzodiazepine use, nor did they experience a faster cognitive decrease.
While the investigators did recognize a small enhanced risk of dementia among subjects with low or moderate benzodiazepine use – the equal to up to 1 month of use or 1-4 months use, accordingly – they recommend this may “represent therapy of prodromal symptoms” of dementia.
“It is also feasible that individuals with prodromal dementia, even years before diagnosis, could be more vulnerable to benzodiazepine-induced acute cognitive adverse events (for example, delirium), causing in discontinuation of the drug and avoidance, in turn resulting in low levels of use,” they add.
Leaving comments on their results, the investigators say:
“All round, our pattern of results does not support the theory that cumulative benzodiazepine use at the levels noticed in our population is causally associated with an enhanced risk of dementia or cognitive decline.”
Still, the team states that thinking about the other adverse effects connected with benzodiazepine use and the fact that proof remains mixed as to whether the drugs may increase the risk for dementia, health care providers “are still recommended to stay away from benzodiazepines in older adults to prevent significant adverse health outcomes, withdrawal, and dependence.”