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Minimal benzodiazepine exposure may slightly increase dementia risk

Recent findings did not indicate a causal association between benzodiazepine use and dementia, though individuals with minimal exposure to benzodiazepines exhibited a slightly higher risk for dementia.

“Single dose studies have shown that benzodiazepines impair aspects of cognition (such as memory and attention). It remains uncertain whether long term use is associated with global cognitive decline,” Shelly L. Gray, PharmD, of the University of Washington, Seattle, and colleagues wrote.

To determine if higher cumulative use of benzodiazepines increases risk for dementia, researchers assessed 3,434 adults aged 65 years and older during a mean follow-up of 7.3 years. Participants, who were dementia-free at baseline, were screened for dementia every two years. Digital pharmacy data ascertained benzodiazepine use.

Overall, 23.2% of participants developed dementia and of these, 79.9% developed Alzheimer’s disease.

Adjusted hazard ratios for dementia associated with cumulative benzodiazepine use were 1.25 (95% CI, 1.03-1.51) for one to 30 total standardized daily doses; 1.31 (95% CI, 1-1.71) for 31 to 120 total standardized daily doses; and 1.07 (95% CI, 0.82-1.39) for 121 or more total standardized daily doses, compared with non-use.

Researchers found similar results for Alzheimer’s disease.

Higher benzodiazepine use was not associated with more rapid cognitive decline, according to researchers.

“Overall, our pattern of findings does not support the theory that cumulative benzodiazepine use at the levels observed in our population is causally related to an increased risk for dementia or cognitive decline,” the researchers wrote. “Nonetheless, given the mixed evidence regarding benzodiazepines and risk of dementia and that these drugs are associated with many adverse events, healthcare providers are still advised to avoid benzodiazepines in older adults to prevent important adverse health outcomes, withdrawal, and dependence.” – by Amanda Oldt

Disclosure: Gray reports no relevant financial disclosures. Please see the full study for a list of all researchers’ relevant financial disclosures.