Frequent sleep medication use tied to long-term dementia risk

Yue Leng

Research presented at the Alzheimer’s Association International Conference revealed that frequent use of sleep medications may increase the long-term risk for dementia, especially among older white adults.

“Sleep medication use is very common in the elderly, but the effects of sleep meds on cognition are poorly understood. Some studies have shown benefits, but others showed risk,” Yue Leng, PhD, from the department of psychiatry, University of California, San Francisco, told Healio Psychiatry. “It is important to understand the association between sleep meds use and dementia risk given how common it is.”

To determine the link between sleep mediation use and dementia risk, Leng and colleagues examined 3,068 black and white community-dwelling older adults without dementia aged 70 to 79 years from the Health, Aging, and Body Composition study, stratifying the analysis by race and sex. They followed participants over 15 years.

Participants were asked whether they took sleeping pills or other medication to help them sleep to assess the frequency of use and could answer “never,” “rarely” (once per month or less), “sometimes” (2 to 4 times per month), “often” (5 to 15 times per month) or “almost always” (16 to 30 times per month). The researchers determined incident dementia based on dementia medication use, hospitalization records or a notable decline in race-specific global cognition score.

Overall, 147 participants reported taking sleep medications “sometimes” and 172 reported “often” or “almost always.” Of these participants who reported a higher frequency of medication use, 34 were black and 138 were white, according to the abstract.

After adjustment for confounders (including APOE4 genotype), Leng and colleagues found that older adults who reported taking sleep medications often or more were 43% (HR =1.43; 95% CI, 1.01-2.02) more likely to develop dementia than those who reported never or rarely taking sleep medications. Furthermore, this association remained after adjusting for nocturnal sleep duration and disturbances.

However, the investigators reported that older adults who reported taking sleep medication sometimes were not at increased risk for dementia.

Although the association did not differ by sex, white participants showed a greater association between frequent sleep medication use and increased dementia risk (HR = 1.79; 95% CI, 1.21-2.66) than black participants (HR = 0.84; 95% CI, 0.38-1.83), according to the results.

“Clinicians should be more cautious about prescribing sleep meds to older adults. For example, behavioral treatment can be considered as a good option,” Leng told Healio Psychiatry. – by Savannah Demko

References:

Leng Y, et al. Sleep medication use and risk of dementia in a biracial cohort of older adults. Presented at: Alzheimer's Association International Conference; July 14-18, 2019; Los Angeles.

Disclosures: Healio Psychiatry was unable to confirm any relevant financial disclosures at the time of publication.