Benzodiazepine use and risk of dementia: prospective population based study
BMJ 2012; 345 doi: 10.1136/bmj.e6231 (Published 27 September 2012)
Cite this as: BMJ 2012;345:e6231
Abstract
Objective
To evaluate the association between use of benzodiazepines and incident dementia.
Design
Prospective, population based study.
Setting
PAQUID study, France.
Participants
1063 men and women (mean age 78.2 years) who were free of dementia and did not start taking benzodiazepines until at least the third year of follow-up.
Main outcome measures
Incident dementia, confirmed by a neurologist.
Results
During a 15 year follow-up, 253 incident cases of dementia were confirmed. New use of benzodiazepines was associated with an increased risk of dementia (multivariable adjusted hazard ratio 1.60, 95% confidence interval 1.08 to 2.38). Sensitivity analysis considering the existence of depressive symptoms showed a similar association (hazard ratio 1.62, 1.08 to 2.43). A secondary analysis pooled cohorts of participants who started benzodiazepines during follow-up and evaluated the association with incident dementia. The pooled hazard ratio across the five cohorts of new benzodiazepine users was 1.46 (1.10 to 1.94). Results of a complementary nested case-control study showed that ever use of benzodiazepines was associated with an approximately 50% increase in the risk of dementia (adjusted odds ratio 1.55, 1.24 to 1.95) compared with never users. The results were similar in past users (odds ratio 1.56, 1.23 to 1.98) and recent users (1.48, 0.83 to 2.63) but reached significance only for past users.
Conclusions
In this prospective population based study, new use of benzodiazepines was associated with increased risk of dementia. The result was robust in pooled analyses across cohorts of new users of benzodiazepines throughout the study and in a complementary case-control study. Considering the extent to which benzodiazepines are prescribed and the number of potential adverse effects of this drug class in the general population, indiscriminate widespread use should be cautioned against.
Mi comentario:
hace años tuve la oportunidad de leer un artículo alemán acerca del mismo tema y no fue hasta el día de hoy que tuve la oportunidad de leer de nuevo acerca del tema y mis observaciones acerca del tema son similares a los resultados del estudio. Es muy frecuente la prescripción de benzodiacepinas en el AM ( adulto mayor) sin medir las consecuencias que esto acarrea, por lo que creo que este artículo es una nueva llamada de atención acerca de la demencia y el uso de éstos medicamentos, lo que nos debe de levar a un uso más racional de los mismos.
BMJ 2012; 345 doi: 10.1136/bmj.e6231 (Published 27 September 2012)
Cite this as: BMJ 2012;345:e6231
Abstract
Objective
To evaluate the association between use of benzodiazepines and incident dementia.
Design
Prospective, population based study.
Setting
PAQUID study, France.
Participants
1063 men and women (mean age 78.2 years) who were free of dementia and did not start taking benzodiazepines until at least the third year of follow-up.
Main outcome measures
Incident dementia, confirmed by a neurologist.
Results
During a 15 year follow-up, 253 incident cases of dementia were confirmed. New use of benzodiazepines was associated with an increased risk of dementia (multivariable adjusted hazard ratio 1.60, 95% confidence interval 1.08 to 2.38). Sensitivity analysis considering the existence of depressive symptoms showed a similar association (hazard ratio 1.62, 1.08 to 2.43). A secondary analysis pooled cohorts of participants who started benzodiazepines during follow-up and evaluated the association with incident dementia. The pooled hazard ratio across the five cohorts of new benzodiazepine users was 1.46 (1.10 to 1.94). Results of a complementary nested case-control study showed that ever use of benzodiazepines was associated with an approximately 50% increase in the risk of dementia (adjusted odds ratio 1.55, 1.24 to 1.95) compared with never users. The results were similar in past users (odds ratio 1.56, 1.23 to 1.98) and recent users (1.48, 0.83 to 2.63) but reached significance only for past users.
Conclusions
In this prospective population based study, new use of benzodiazepines was associated with increased risk of dementia. The result was robust in pooled analyses across cohorts of new users of benzodiazepines throughout the study and in a complementary case-control study. Considering the extent to which benzodiazepines are prescribed and the number of potential adverse effects of this drug class in the general population, indiscriminate widespread use should be cautioned against.
Mi comentario:
hace años tuve la oportunidad de leer un artículo alemán acerca del mismo tema y no fue hasta el día de hoy que tuve la oportunidad de leer de nuevo acerca del tema y mis observaciones acerca del tema son similares a los resultados del estudio. Es muy frecuente la prescripción de benzodiacepinas en el AM ( adulto mayor) sin medir las consecuencias que esto acarrea, por lo que creo que este artículo es una nueva llamada de atención acerca de la demencia y el uso de éstos medicamentos, lo que nos debe de levar a un uso más racional de los mismos.
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