Benzodiazepine use and the risk of dementia
Abstract Introduction Benzodiazepines (BZDs) are commonly prescribed for anxiety and agitations, which are early symptoms of Alzheimer's disease and related dementias (ADRD). It is unclear whether BZDs causally affect ADRD risk or are prescribed in response to early symptoms of dementia. Method...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Alzheimer’s & Dementia: Translational Research & Clinical Interventions |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/trc2.12309 |
| _version_ | 1826950819048587264 |
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| author | Geoffrey Joyce Patricia Ferido Johanna Thunell Bryan Tysinger Julie Zissimopoulos |
| author_facet | Geoffrey Joyce Patricia Ferido Johanna Thunell Bryan Tysinger Julie Zissimopoulos |
| author_sort | Geoffrey Joyce |
| collection | DOAJ |
| description | Abstract Introduction Benzodiazepines (BZDs) are commonly prescribed for anxiety and agitations, which are early symptoms of Alzheimer's disease and related dementias (ADRD). It is unclear whether BZDs causally affect ADRD risk or are prescribed in response to early symptoms of dementia. Methods We replicate prior case‐control studies using longitudinal Medicare claims. To mitigate bias from prodromal use, we compare rates of ADRD diagnosis for beneficiaries exposed and unexposed to BZDs for cervical/lumbar pain, stenosis, and sciatica, none of which are associated with dementia. Results Approximately 8% of Medicare beneficiaries used a BZD in 2007, increasing to nearly 13% by 2013. Estimates from case‐control designs are sensitive to duration of look‐back period, health histories, medication use, and exclusion of decedents. Incident BZD use is not associated with an increased risk of dementia in an “uncontaminated” sample of beneficiaries prescribed a BZD for pain (odds ratios (ORs) of 1.007 [95% confidence interval [CI] = 0.885, 1.146] and 0.986 [95% CI = 0.877, 1.108], respectively, in the 2013 and 2013 to 2015 pooled samples). Higher levels of BZD exposure (>365 days over a 2‐year period) are associated with increased odds of a dementia diagnosis, but the results are not statistically significant at the 5% or 10% levels (1.190 [95% CI = 0.925, 1.531] and 1.167 [95% CI = 0.919, 1.483]). Discussion We find little evidence of a causal relation between BZD use and dementia risk. Nonetheless, providers should limit the extended use in elderly populations. |
| first_indexed | 2024-04-10T21:53:57Z |
| format | Article |
| id | doaj.art-ffff1b60a5f34233be2e6960fdfe1640 |
| institution | Directory Open Access Journal |
| issn | 2352-8737 |
| language | English |
| last_indexed | 2025-02-17T22:37:48Z |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Alzheimer’s & Dementia: Translational Research & Clinical Interventions |
| spelling | doaj.art-ffff1b60a5f34233be2e6960fdfe16402024-12-03T12:37:31ZengWileyAlzheimer’s & Dementia: Translational Research & Clinical Interventions2352-87372022-01-0181n/an/a10.1002/trc2.12309Benzodiazepine use and the risk of dementiaGeoffrey Joyce0Patricia Ferido1Johanna Thunell2Bryan Tysinger3Julie Zissimopoulos4University of Southern California (USC) Schaeffer Center for Health Policy and Economics Los Angeles CA Los Angeles CountyUniversity of Southern California (USC) Schaeffer Center for Health Policy and Economics Los Angeles CA Los Angeles CountyUniversity of Southern California (USC) Schaeffer Center for Health Policy and Economics Los Angeles CA Los Angeles CountyUniversity of Southern California (USC) Schaeffer Center for Health Policy and Economics Los Angeles CA Los Angeles CountyUniversity of Southern California (USC) Schaeffer Center for Health Policy and Economics Los Angeles CA Los Angeles CountyAbstract Introduction Benzodiazepines (BZDs) are commonly prescribed for anxiety and agitations, which are early symptoms of Alzheimer's disease and related dementias (ADRD). It is unclear whether BZDs causally affect ADRD risk or are prescribed in response to early symptoms of dementia. Methods We replicate prior case‐control studies using longitudinal Medicare claims. To mitigate bias from prodromal use, we compare rates of ADRD diagnosis for beneficiaries exposed and unexposed to BZDs for cervical/lumbar pain, stenosis, and sciatica, none of which are associated with dementia. Results Approximately 8% of Medicare beneficiaries used a BZD in 2007, increasing to nearly 13% by 2013. Estimates from case‐control designs are sensitive to duration of look‐back period, health histories, medication use, and exclusion of decedents. Incident BZD use is not associated with an increased risk of dementia in an “uncontaminated” sample of beneficiaries prescribed a BZD for pain (odds ratios (ORs) of 1.007 [95% confidence interval [CI] = 0.885, 1.146] and 0.986 [95% CI = 0.877, 1.108], respectively, in the 2013 and 2013 to 2015 pooled samples). Higher levels of BZD exposure (>365 days over a 2‐year period) are associated with increased odds of a dementia diagnosis, but the results are not statistically significant at the 5% or 10% levels (1.190 [95% CI = 0.925, 1.531] and 1.167 [95% CI = 0.919, 1.483]). Discussion We find little evidence of a causal relation between BZD use and dementia risk. Nonetheless, providers should limit the extended use in elderly populations.https://doi.org/10.1002/trc2.12309Benzodiazepinescase‐control designscausal estimatesdementia riskMedicare beneficiaries |
| spellingShingle | Geoffrey Joyce Patricia Ferido Johanna Thunell Bryan Tysinger Julie Zissimopoulos Benzodiazepine use and the risk of dementia Alzheimer’s & Dementia: Translational Research & Clinical Interventions Benzodiazepines case‐control designs causal estimates dementia risk Medicare beneficiaries |
| title | Benzodiazepine use and the risk of dementia |
| title_full | Benzodiazepine use and the risk of dementia |
| title_fullStr | Benzodiazepine use and the risk of dementia |
| title_full_unstemmed | Benzodiazepine use and the risk of dementia |
| title_short | Benzodiazepine use and the risk of dementia |
| title_sort | benzodiazepine use and the risk of dementia |
| topic | Benzodiazepines case‐control designs causal estimates dementia risk Medicare beneficiaries |
| url | https://doi.org/10.1002/trc2.12309 |
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