Kevin J Friesen , Jamie Falk , I Fan Kuo , Alexander Singer , Shawn Bugden
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引用次数: 0
Abstract
Objective
To examine the relationship between duration of benzodiazepine exposure and the risk of dementia.
Design
A retrospective cohort study using administrative health data followed 3 age-based strata (ages 55, 65 and 75) for up to a maximum of 22 years to examine risk of dementia due to benzodiazepine use. Each stratum was analyzed as a whole, then restricted to persons with depression or anxiety, and finally using high dimension propensity scores (HDPS) matched cohort.
Setting
We used administrative data on subjects receiving standard medical care in Manitoba, Canada.
Measurements
Prescription data was used to quantify benzodiazepine using cumulative defined-daily-dose (DDD). Comorbidities and cases of dementia were determined using medical and hospital data.
Results
Dementia risk in high-dose users of the youngest strata was elevated compared to non-users (adjusted HR (aHR) 1.33; 95 % CI 1.05–1.68)). Little to no difference was found in the middle (aHR 1.17; 1.02–1.33) and oldest strata (aHR 1.02; 0.93–1.11). Restriction to persons with depression or anxiety eliminated the association. No association was found using HDPS-matched comparison groups.
Conclusions
Only a modest increase in dementia risk was seen in the high-dose benzodiazepine users. This association appears to be driven by the confounding due to higher rates of diabetes, cardiovascular disease, depression, and anxiety among users. Using restriction or HDPS to better control for confounding effects eliminates the association. While benzodiazepines do not appear to be a significant risk factor for dementia, tolerance, dependency and adverse effects caution against their long-term use.
期刊介绍:
Archives of Gerontology and Geriatrics provides a medium for the publication of papers from the fields of experimental gerontology and clinical and social geriatrics. The principal aim of the journal is to facilitate the exchange of information between specialists in these three fields of gerontological research. Experimental papers dealing with the basic mechanisms of aging at molecular, cellular, tissue or organ levels will be published.
Clinical papers will be accepted if they provide sufficiently new information or are of fundamental importance for the knowledge of human aging. Purely descriptive clinical papers will be accepted only if the results permit further interpretation. Papers dealing with anti-aging pharmacological preparations in humans are welcome. Papers on the social aspects of geriatrics will be accepted if they are of general interest regarding the epidemiology of aging and the efficiency and working methods of the social organizations for the health care of the elderly.