Abstract
The objective of this article was to examine the possible association between benzodiazepine
use and the risk of dementia in the elderly. This was a nested case–control study
set in community settings in Bordeaux area, France. The participants were a representative
sample of 3,777 elderly persons (65 years of age and older) followed from 1989 to
1997. The main outcome measures were the use of benzodiazepines in incident cases
of dementia versus nondemented controls. On the basis of medical and psychological
data, 150 patients were diagnosed with dementia according to the criteria of the third
revision of the Diagnostic and Statistical Manual of Mental Disorders. Information
on benzodiazepine use was obtained by face-to-face interview and visual assessment
of patient's medicine chest by a trained neuropsychologist. After controlling for
age, gender, education level, living alone, wine consumption, psychiatric history,
and depressive symptomatology, ever use of benzodiazepines was associated with a significantly increased risk of dementia
[adjusted odds ratio (OR), 1.7; 95% confidence interval, 1.2–2.4]. Former use was associated with a significantly increased risk of dementia (adjusted OR, 2.3;
95% CI,1.2–4.5). No association was found between dementia and the current use of
benzodiazepines (adjusted OR, 1.0; 95% CI, 0.6–1.6). Our finding suggest that former
use of benzodiazepines could be a risk factor for dementia, but more detailed investigation
are needed.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Clinical EpidemiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Benzodiazepines and zolpidem for chronic insomnia.JAMA. 1997; 278: 2170-2177
- Hypnotics in the elderly. What cause for concern?.Drugs. 1990; 40: 688-696
- Prevalence and correlates of the long-term regular use of anxiolytics.JAMA. 1984; 251: 375-379
- Rational use of benzodiazepines in the elderly.Drugs Aging. 1994; 4: 9-20
Lecomte T. La consommation pharmaceutique en 1988, évolution 1980–1988.Rapport C.R.E.D.E.S, 1991;888. Available at http://www. credes.fr/Chiffres/sommaire.htm.
Guignon N, Mormiche P, Sermet C. La consommation régulière de psychotropes. INSEE Première 1994;310. Available at http://www. INSEE.fr/vf/produits/pub/prem/ipart/ip310r.htm.
- Presciption of psychotropic drugs; use, misuse and abuse.Bull Acad Natl Med. 1998; 182: 1439-1447
- Use of benzodiazepines in anxiety disorders.N Engl J Med. 1993; 328: 1398-1405
- Drug-induced dementia.Drug Saf. 1994; 11: 310-317
- Drug-induced cognitive impairment. Defining the problem and finding solutions.Drugs Aging. 1993; 3: 349-357
- Benzodiazepines and vigilance performance.Psychopharmacology (Berlin). 1989; 98: 145-156
- Memory performance in individuals with primary degenerative dementia.Exp Aging Res. 1985; 11: 151-155
- Effects of chronic benzodiazepine administration on neuropsychological performance.Clin Neuropharmacol. 1985; 8: 357-361
- Side-effect “tolerance” in elderly long-term recipients of benzodiazepine hypnotics.Age Ageing. 1984; 13: 335-343
- Withdrawal reaction after long-term therapeutic use of benzodiazepines.N Engl J Med. 1986; 315: 854-859
- Sensitivity to triazolam in the elderly.N Engl J Med. 1991; 324: 1691-1698
- Implications of altered drug disposition in the elderly.J Clin Pharmacol. 1989; 29: 866-872
- Risk of syncope in the elderly and consumption of drugs.J Clin Epidemiol. 1997; 50: 313-320
- Benzodiazepine use in older, community-dwelling Southern Californians.Ann Pharmacother. 1993; 27: 416-421
- Impairment of performance associated with long-term use of benzodiazepines.J Psychopharmacol. 1995; 9: 313-318
- Benzodiazepines may have protective effects against Alzheimer disease.Alzheimer Dis Assoc Disord. 1998; 12: 14-17
- Occupation during life and memory performance in nondemented French elderly community residents.Neurology. 1992; 42: 1697-1701
- La maladie d'Alzheimer et les syndromes apparentés. Résultats principaux de l'enquête de cohorte Paquid.Psychol Med. 1996; numéro: 109-112
- Diagnostic and statistical manual of mental disorders. 3rd ed., rev. American Psychiatric Association, Washinton, DC1987
- Epidemiologic approach to the study of dementing diseases.Neuroepidemiology. 1992; 11: 114-118
- Practical considerations in choosing between the case–control and nested case–control designs.Epidemiology. 1991; 2: 155-158
- Selection of controls in case–control studies. I. Principles. II. Types of controls. III. Design options.Am J Epidemiol. 1992; 135: 1019-1050
- Biased selection of controls for case–control analysis of cohort studies.Biometrics. 1984; 40: 63-75
- Revision 4. Reference manual. Statistics and Epidemiology Research Corporation and Cytel Software Corporation, Seattle1993
- Use of the center for epidemiological studies. In.Clin Gerontol. 1986; 6: 119-136
- Medication consumtion by the elderly living at home and in institution on the basis of the paquid cohort.Rev Geriatr. 1996; 21: 473-482
- Benzodiazepines and hip fractures in elderly people.BMJ. 2001; 322: 704-708
- Dictionnary of pharmacoepidemiology. John Wiley & Sons, Chichester2000
- Evidence of the depletion of susceptibles effect in non-experimental pharmacoepidemiology reseach.J Clin Epidemiol. 1994; 47: 731-737
- Principles of nonexperimental assessment of excess risk, with special reference to adverse drug reactions.J Clin Epidemiol. 1989; 42: 325-331
- The protective effect of moderate alcohol consumption on ischemic stroke.JAMA. 1999; 281: 53-60
Fourrier A, Letenneur L, Dartigues JF, Moore N, Bégaud B. Benzodiazepine use in an elderly community-dwelling population: characteristics of users and factors associated with subsequent use. Eur J Clin Pharmacol, in press.
- Benzodiazepine use and cognitive function among community-dwelling elderly.Clin Pharmacol Ther. 1998; 64: 684-692
- Psychotropic drug use and cognitive decline among older men and women.Int J Geriatr Psychiatry. 1997; 12: 567-574
Article info
Publication history
Accepted:
August 16,
2001
Received in revised form:
July 28,
2001
Received:
October 9,
2000
Identification
Copyright
© 2002 Elsevier Science Inc. Published by Elsevier Inc. All rights reserved.
