Benzodiazepines associated with increased risk for pneumonia in Alzheimer’s disease

Benzodiazepines, a class of commonly used sedatives, were linked with an increased risk for pneumonia among patients with Alzheimer disease, according to findings from a newly published study from Finland.

“Use of benzodiazepines and similarly acting non-benzodiazepines is frequent among those with Alzheimer disease, and many patients use the drugs long term, although clinical care guidelines recommend only short-term use,” Heidi Taipale, PhD Pharm, of the Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland, and colleagues wrote.

The researchers noted that two studies, one in the U.K. and one in the U.S., reported conflicting findings on the association between benzodiazepines and pneumonia. They also pointed out that dementia is a risk factor for pneumonia.

“Knowledge regarding whether benzodiazepines and similarly acting non-benzodiazepines (Z-drugs) are associated with an increased risk of pneumonia among older adults is lacking,” Taipale and colleagues wrote.

The researchers used a medical database to gather information on community-dwelling Finnish patients who were diagnosed with Alzheimer’s disease between 2005 and 2011. Taipale and colleagues matched 5,232 patients who were taking benzodiazepines and 3,269 taking Z-drugs with patients who were not taking either medication. Researchers used a Cox proportional hazards model to identify any association with hospital admission or death due to pneumonia, adjusting for the use of other psychotropic drugs in the analysis.

Mean age was 80 years, and most patients (62.7%) were women.

Overall, both benzodiazepines and Z-drugs were associated with an increased risk for developing pneumonia, the researchers reported (HR = 1.22; 95% CI, 1.05-1.42). When Taipale and colleagues analyzed the drugs separately, researchers reported a significantly increased risk for pneumonia with benzodiazepines (HR = 1.28; 95% CI, 1.07-1.54), whereas Z-drug use did not show an increased risk (HR = 1.10; 95% CI, 0.84-1.44). Pneumonia risk was greatest within the first 30 days of using benzodiazepines (HR = 2.09; 95% CI, 1.26-3.48).

“An increased risk of pneumonia is an important finding to consider in treatment of patients with Alzheimer disease,” Taipale and colleagues wrote. “Benzodiazepines and Z-drugs are frequently prescribed for this population, and long-term use is typical. Pneumonia often leads to admission to hospital, and patients with dementia are at increased risk of death related to pneumonia. Benefits and risks of the use of benzodiazepines should be carefully considered for patients with Alzheimer disease.” – by Andy Polhamus

Disclosure: The researchers report no relevant financial disclosures.