Benzodiazepine and Z-Drug Use and the Risk of Developing Dementia
Abstract Background Benzodiazepines (BZDs) and Z-drugs (BZDRs) are among the most prescribed medications for anxiety and insomnia, especially among older adults. Our objective was to investigate the association between the use of BZDRs and the risk of dementia. Methods A community-based retrospectiv...
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| Veröffentlicht in: | The international journal of neuropsychopharmacology 2022-04, Vol.25 (4), p.261-268 |
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| container_title | The international journal of neuropsychopharmacology |
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| creator | Torres-Bondia, Francisco Dakterzada, Farida Galván, Leonardo Buti, Miquel Besanson, Gaston Grill, Eric Buil, Roman de Batlle, Jordi Piñol-Ripoll, Gerard |
| description | Abstract
Background
Benzodiazepines (BZDs) and Z-drugs (BZDRs) are among the most prescribed medications for anxiety and insomnia, especially among older adults. Our objective was to investigate the association between the use of BZDRs and the risk of dementia.
Methods
A community-based retrospective cohort study was conducted based on the data available from 2002 to 2015 in Catalan Health Service. This cohort included all BZDR users (N = 83 138) and nonusers (N = 84 652) older than 45 years. A minimum 5-year lag window and an adjustment for psychiatric problems were applied for the data analysis.
Results
The hazard ratio (HR) for the risk of incident dementia among BZDR users was 1.22 (95% CI = 1.15 to 1.31). This risk was not significant after adjusting the data confounding factors (HR = 1.01; 95% CI = 0.94 to 1.08). We observed a higher risk with short-to-intermediate half-life BZDs (HR = 1.11; 95% CI = 1.04 to 1.20) and Z-drugs (HR = 1.20; 95% CI = 1.07 to 1.33) than for intermediate-to-long half-life BZDs (HR = 1.01; 95% CI = 0.94 to 1.08). We demonstrated a higher risk of incident dementia (HR = 1.23; 95% CI = 1.07 to 1.41 and odds ratio = 1.38; 95% CI = 1.27 to 1.50, respectively) in patients who received 91 to 180 defined daily doses (DDDs) and >180 DDDs compared with patients who received |
| doi_str_mv | 10.1093/ijnp/pyab073 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9017765</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A711329897</galeid><oup_id>10.1093/ijnp/pyab073</oup_id><sourcerecordid>A711329897</sourcerecordid><originalsourceid>FETCH-LOGICAL-c483t-de78c35c1fe6e0e231351280f76e15d7f4dc07348983dfb503206487f5a5dc3a3</originalsourceid><addsrcrecordid>eNp9kc9rFTEQx4Mo9ofePJcFD_bgtplNstm9FJ6tVqEgiL14CXnJ5DXtbrLdvC20f7157muxIJLDTCaf-WaGLyHvgB4Bbdmxvw7D8XCvl1SyF2QXeN2WAgBe_smhBC7kDtlL6ZrSigtWvyY7jMtKguS7ZPEJw0O0Xj_g4AMWOtjiV3k2TqviMs3X9RUWP3y6KaIrzvAOu5jJVU57DGuv35BXTncJ327jPrn88vnn6dfy4vv5t9PFRWl4w9alRdkYJgw4rJFixYAJqBrqZI0grHTcmrwBb9qGWbcUlFW05o10QgtrmGb75GTWHaZlj9bkz0fdqWH0vR7vVdRePX8J_kqt4p1qKUhZiyxwuBUY4-2Eaa16nwx2nQ4Yp6Qq0TLK8gRNRt_P6Ep3qHxwMSuaDa4WEoBVbdPKTB39g8rHYu9NDOh8rj9r-Dg3mDGmNKJ7mh6o2pipNmaqrZkZP_h74yf40b0MfJiBOA3_l_oNV7Gn4w</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2593033488</pqid></control><display><type>article</type><title>Benzodiazepine and Z-Drug Use and the Risk of Developing Dementia</title><source>Oxford Journals Open Access Collection</source><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Torres-Bondia, Francisco ; Dakterzada, Farida ; Galván, Leonardo ; Buti, Miquel ; Besanson, Gaston ; Grill, Eric ; Buil, Roman ; de Batlle, Jordi ; Piñol-Ripoll, Gerard</creator><creatorcontrib>Torres-Bondia, Francisco ; Dakterzada, Farida ; Galván, Leonardo ; Buti, Miquel ; Besanson, Gaston ; Grill, Eric ; Buil, Roman ; de Batlle, Jordi ; Piñol-Ripoll, Gerard</creatorcontrib><description>Abstract
Background
Benzodiazepines (BZDs) and Z-drugs (BZDRs) are among the most prescribed medications for anxiety and insomnia, especially among older adults. Our objective was to investigate the association between the use of BZDRs and the risk of dementia.
Methods
A community-based retrospective cohort study was conducted based on the data available from 2002 to 2015 in Catalan Health Service. This cohort included all BZDR users (N = 83 138) and nonusers (N = 84 652) older than 45 years. A minimum 5-year lag window and an adjustment for psychiatric problems were applied for the data analysis.
Results
The hazard ratio (HR) for the risk of incident dementia among BZDR users was 1.22 (95% CI = 1.15 to 1.31). This risk was not significant after adjusting the data confounding factors (HR = 1.01; 95% CI = 0.94 to 1.08). We observed a higher risk with short-to-intermediate half-life BZDs (HR = 1.11; 95% CI = 1.04 to 1.20) and Z-drugs (HR = 1.20; 95% CI = 1.07 to 1.33) than for intermediate-to-long half-life BZDs (HR = 1.01; 95% CI = 0.94 to 1.08). We demonstrated a higher risk of incident dementia (HR = 1.23; 95% CI = 1.07 to 1.41 and odds ratio = 1.38; 95% CI = 1.27 to 1.50, respectively) in patients who received 91 to 180 defined daily doses (DDDs) and >180 DDDs compared with patients who received <90 DDD. Regarding patient sex, the risk of dementia was higher in women than in men.
Conclusion
We found that the incidence of dementia was not higher among all BZDR users. Short half-life BZDs and Z-drugs increased the risk of dementia at the highest doses, especially in female patients, showing a dose-response relationship.</description><identifier>ISSN: 1461-1457</identifier><identifier>EISSN: 1469-5111</identifier><identifier>DOI: 10.1093/ijnp/pyab073</identifier><identifier>PMID: 34727174</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Aged ; Benzodiazepines ; Benzodiazepines - adverse effects ; Cohort Studies ; Complications and side effects ; Dementia ; Dementia - chemically induced ; Dementia - epidemiology ; Drug therapy ; Female ; Humans ; Male ; Middle aged persons ; Psychological aspects ; Regular s ; Retrospective Studies ; Risk Factors ; Statistics ; Substance-Related Disorders - drug therapy</subject><ispartof>The international journal of neuropsychopharmacology, 2022-04, Vol.25 (4), p.261-268</ispartof><rights>The Author(s) 2021. Published by Oxford University Press on behalf of CINP. 2021</rights><rights>The Author(s) 2021. Published by Oxford University Press on behalf of CINP.</rights><rights>COPYRIGHT 2022 Oxford University Press</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-de78c35c1fe6e0e231351280f76e15d7f4dc07348983dfb503206487f5a5dc3a3</citedby><cites>FETCH-LOGICAL-c483t-de78c35c1fe6e0e231351280f76e15d7f4dc07348983dfb503206487f5a5dc3a3</cites><orcidid>0000-0002-4495-2113</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9017765/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9017765/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,1598,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34727174$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Torres-Bondia, Francisco</creatorcontrib><creatorcontrib>Dakterzada, Farida</creatorcontrib><creatorcontrib>Galván, Leonardo</creatorcontrib><creatorcontrib>Buti, Miquel</creatorcontrib><creatorcontrib>Besanson, Gaston</creatorcontrib><creatorcontrib>Grill, Eric</creatorcontrib><creatorcontrib>Buil, Roman</creatorcontrib><creatorcontrib>de Batlle, Jordi</creatorcontrib><creatorcontrib>Piñol-Ripoll, Gerard</creatorcontrib><title>Benzodiazepine and Z-Drug Use and the Risk of Developing Dementia</title><title>The international journal of neuropsychopharmacology</title><addtitle>Int J Neuropsychopharmacol</addtitle><description>Abstract
Background
Benzodiazepines (BZDs) and Z-drugs (BZDRs) are among the most prescribed medications for anxiety and insomnia, especially among older adults. Our objective was to investigate the association between the use of BZDRs and the risk of dementia.
Methods
A community-based retrospective cohort study was conducted based on the data available from 2002 to 2015 in Catalan Health Service. This cohort included all BZDR users (N = 83 138) and nonusers (N = 84 652) older than 45 years. A minimum 5-year lag window and an adjustment for psychiatric problems were applied for the data analysis.
Results
The hazard ratio (HR) for the risk of incident dementia among BZDR users was 1.22 (95% CI = 1.15 to 1.31). This risk was not significant after adjusting the data confounding factors (HR = 1.01; 95% CI = 0.94 to 1.08). We observed a higher risk with short-to-intermediate half-life BZDs (HR = 1.11; 95% CI = 1.04 to 1.20) and Z-drugs (HR = 1.20; 95% CI = 1.07 to 1.33) than for intermediate-to-long half-life BZDs (HR = 1.01; 95% CI = 0.94 to 1.08). We demonstrated a higher risk of incident dementia (HR = 1.23; 95% CI = 1.07 to 1.41 and odds ratio = 1.38; 95% CI = 1.27 to 1.50, respectively) in patients who received 91 to 180 defined daily doses (DDDs) and >180 DDDs compared with patients who received <90 DDD. Regarding patient sex, the risk of dementia was higher in women than in men.
Conclusion
We found that the incidence of dementia was not higher among all BZDR users. Short half-life BZDs and Z-drugs increased the risk of dementia at the highest doses, especially in female patients, showing a dose-response relationship.</description><subject>Aged</subject><subject>Benzodiazepines</subject><subject>Benzodiazepines - adverse effects</subject><subject>Cohort Studies</subject><subject>Complications and side effects</subject><subject>Dementia</subject><subject>Dementia - chemically induced</subject><subject>Dementia - epidemiology</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle aged persons</subject><subject>Psychological aspects</subject><subject>Regular s</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Statistics</subject><subject>Substance-Related Disorders - drug therapy</subject><issn>1461-1457</issn><issn>1469-5111</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><sourceid>EIF</sourceid><recordid>eNp9kc9rFTEQx4Mo9ofePJcFD_bgtplNstm9FJ6tVqEgiL14CXnJ5DXtbrLdvC20f7157muxIJLDTCaf-WaGLyHvgB4Bbdmxvw7D8XCvl1SyF2QXeN2WAgBe_smhBC7kDtlL6ZrSigtWvyY7jMtKguS7ZPEJw0O0Xj_g4AMWOtjiV3k2TqviMs3X9RUWP3y6KaIrzvAOu5jJVU57DGuv35BXTncJ327jPrn88vnn6dfy4vv5t9PFRWl4w9alRdkYJgw4rJFixYAJqBrqZI0grHTcmrwBb9qGWbcUlFW05o10QgtrmGb75GTWHaZlj9bkz0fdqWH0vR7vVdRePX8J_kqt4p1qKUhZiyxwuBUY4-2Eaa16nwx2nQ4Yp6Qq0TLK8gRNRt_P6Ep3qHxwMSuaDa4WEoBVbdPKTB39g8rHYu9NDOh8rj9r-Dg3mDGmNKJ7mh6o2pipNmaqrZkZP_h74yf40b0MfJiBOA3_l_oNV7Gn4w</recordid><startdate>20220419</startdate><enddate>20220419</enddate><creator>Torres-Bondia, Francisco</creator><creator>Dakterzada, Farida</creator><creator>Galván, Leonardo</creator><creator>Buti, Miquel</creator><creator>Besanson, Gaston</creator><creator>Grill, Eric</creator><creator>Buil, Roman</creator><creator>de Batlle, Jordi</creator><creator>Piñol-Ripoll, Gerard</creator><general>Oxford University Press</general><scope>TOX</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4495-2113</orcidid></search><sort><creationdate>20220419</creationdate><title>Benzodiazepine and Z-Drug Use and the Risk of Developing Dementia</title><author>Torres-Bondia, Francisco ; Dakterzada, Farida ; Galván, Leonardo ; Buti, Miquel ; Besanson, Gaston ; Grill, Eric ; Buil, Roman ; de Batlle, Jordi ; Piñol-Ripoll, Gerard</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c483t-de78c35c1fe6e0e231351280f76e15d7f4dc07348983dfb503206487f5a5dc3a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aged</topic><topic>Benzodiazepines</topic><topic>Benzodiazepines - adverse effects</topic><topic>Cohort Studies</topic><topic>Complications and side effects</topic><topic>Dementia</topic><topic>Dementia - chemically induced</topic><topic>Dementia - epidemiology</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle aged persons</topic><topic>Psychological aspects</topic><topic>Regular s</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Statistics</topic><topic>Substance-Related Disorders - drug therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Torres-Bondia, Francisco</creatorcontrib><creatorcontrib>Dakterzada, Farida</creatorcontrib><creatorcontrib>Galván, Leonardo</creatorcontrib><creatorcontrib>Buti, Miquel</creatorcontrib><creatorcontrib>Besanson, Gaston</creatorcontrib><creatorcontrib>Grill, Eric</creatorcontrib><creatorcontrib>Buil, Roman</creatorcontrib><creatorcontrib>de Batlle, Jordi</creatorcontrib><creatorcontrib>Piñol-Ripoll, Gerard</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The international journal of neuropsychopharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Torres-Bondia, Francisco</au><au>Dakterzada, Farida</au><au>Galván, Leonardo</au><au>Buti, Miquel</au><au>Besanson, Gaston</au><au>Grill, Eric</au><au>Buil, Roman</au><au>de Batlle, Jordi</au><au>Piñol-Ripoll, Gerard</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Benzodiazepine and Z-Drug Use and the Risk of Developing Dementia</atitle><jtitle>The international journal of neuropsychopharmacology</jtitle><addtitle>Int J Neuropsychopharmacol</addtitle><date>2022-04-19</date><risdate>2022</risdate><volume>25</volume><issue>4</issue><spage>261</spage><epage>268</epage><pages>261-268</pages><issn>1461-1457</issn><eissn>1469-5111</eissn><abstract>Abstract
Background
Benzodiazepines (BZDs) and Z-drugs (BZDRs) are among the most prescribed medications for anxiety and insomnia, especially among older adults. Our objective was to investigate the association between the use of BZDRs and the risk of dementia.
Methods
A community-based retrospective cohort study was conducted based on the data available from 2002 to 2015 in Catalan Health Service. This cohort included all BZDR users (N = 83 138) and nonusers (N = 84 652) older than 45 years. A minimum 5-year lag window and an adjustment for psychiatric problems were applied for the data analysis.
Results
The hazard ratio (HR) for the risk of incident dementia among BZDR users was 1.22 (95% CI = 1.15 to 1.31). This risk was not significant after adjusting the data confounding factors (HR = 1.01; 95% CI = 0.94 to 1.08). We observed a higher risk with short-to-intermediate half-life BZDs (HR = 1.11; 95% CI = 1.04 to 1.20) and Z-drugs (HR = 1.20; 95% CI = 1.07 to 1.33) than for intermediate-to-long half-life BZDs (HR = 1.01; 95% CI = 0.94 to 1.08). We demonstrated a higher risk of incident dementia (HR = 1.23; 95% CI = 1.07 to 1.41 and odds ratio = 1.38; 95% CI = 1.27 to 1.50, respectively) in patients who received 91 to 180 defined daily doses (DDDs) and >180 DDDs compared with patients who received <90 DDD. Regarding patient sex, the risk of dementia was higher in women than in men.
Conclusion
We found that the incidence of dementia was not higher among all BZDR users. Short half-life BZDs and Z-drugs increased the risk of dementia at the highest doses, especially in female patients, showing a dose-response relationship.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>34727174</pmid><doi>10.1093/ijnp/pyab073</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-4495-2113</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Oxford Journals Open Access Collection; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Aged Benzodiazepines Benzodiazepines - adverse effects Cohort Studies Complications and side effects Dementia Dementia - chemically induced Dementia - epidemiology Drug therapy Female Humans Male Middle aged persons Psychological aspects Regular s Retrospective Studies Risk Factors Statistics Substance-Related Disorders - drug therapy |
| title | Benzodiazepine and Z-Drug Use and the Risk of Developing Dementia |
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