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Home > Over 65s at increased risk of developing dementia with benzodiazepines.

[Irish Medical Times] Over 65s at increased risk of developing dementia with benzodiazepines. (04 Oct 2012)

URL: http://www.imt.ie/clinical/2012/10/over-65s-at-inc...

Patients over the age of 65 years who begin taking benzodiazepines are at an approximately 50 per cent increased risk of developing dementia within 15 years compared to never-users, a new study suggests.



The authors say that considering the extent to which benzodiazepines are prescribed and the number of potential adverse effects, “indiscriminate, widespread use should be cautioned against”.

Benzodiazepine is a widely-prescribed drug for the over-65s in many countries: 30 per cent of this age group in France; 20 per cent in Canada and Spain; and 15 per cent in Australia, the report published on bmj.com states.

Although less widespread in the UK and US, it is still very widely used and many individuals take this drug for years, despite guidelines suggesting it should be limited to a few weeks. Previous studies have found an increased risk of dementia, but others have been non-conclusive.

Researchers from France therefore carried out a study on 1,063 men and women (average age 78) who were all free of dementia at the start. The study started in 1987 and follow-up was 20 years.

The researchers used the first five years to identify the factors leading to benzodiazepine initiation and then evaluated the association between new use of this drug and the development of dementia. They also assessed the association between further benzodiazepine initiation during the follow-up period and risk of subsequent dementia.

Some 95 out of the 1,063 patients started taking benzodiazepines during the study. A total of 253 (23.8 per cent) cases of dementia were confirmed, 30 in benzodiazepine users and 223 in non-users. New initiation of the drug was associated with shorter dementia-free survival.

In absolute numbers, the chance of dementia occurring was 4.8 per 100 person-years in the exposed group, compared to 3.2 per 100 person-years in the non-exposed group.

They said that their data add to the accumulating evidence that the use of benzodiazepines is associated with increased risk of dementia and, if true, that this “would constitute a substantial public health concern”.

Therefore, taking the evidence of potential adverse effects into account, physicians should assess expected benefits, limit prescriptions to a few weeks, and uncontrolled use should be cautioned against.

 

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