Objective: Benzodiazepines are a widely used class of medications for anxiety, depression, and insomnia. Despite their common use, concerns remain about memory problems with benzodiazepines. Despite the growing financial and social burden of dementia, inconsistent results persist regarding the association between benzodiazepines and dementia. Therefore, we aimed to evaluate the association between benzodiazepines and dementia in Korea. Methods: Diagnostic and prescription information from the Health Insurance Review and Assessment (HIRA) database in South Korea between 2009 and 2014 was utilized. The dementia group included people who were diagnosed with a dementia code and received one or more prescriptions for dementia. A total of 68,241 participants with dementia and 341,205 control participants were matched. Possible confounders, such as major medical and psychiatric disorders, were adjusted, and multivariate logistic regression was conducted to assess the association between benzodiazepines and dementia. Results: The highest odds ratio (OR) for dementia was noted for clonazepam (OR=2.86, 95% confidence interval [CI]=2.77–2.95) followed by those for diazepam (OR=2.60, 95% CI=2.53–2.66), lorazepam (OR=1.34, 95% CI=1.30–1.37), and triazolam (OR=1.26, 95% CI=1.21–1.32). Conclusion: Overall, relatively long-acting benzodiazepines, such as clonazepam, diazepam, and lorazepam, were associated with the incidence of dementia. Triazolam, which is approved for insomnia, was also significantly associated with dementia. Individuals who are prescribed with benzodiazepines should be cautious regarding memory loss and dementia. Further studies are needed to confirm the temporal and biological causality between benzodiazepines and dementia.

In this study, the Search Your Mind (S.Y.M., 心) project aimed to collect prospective digital phenotypic data centered on mood and anxiety symptoms across psychiatric disorders through a smartphone application (app) platform while using both centralized and decentralized research designs: the centralized research design is a hybrid of a general prospective observational study and a digital platform-based study, and it includes face-to-face research such as informed written consent, clinical evaluation, and blood sampling. It also includes digital phenotypic assessment through an application-based platform using wearable devices. Meanwhile, the decentralized research design is a non-face-to-face study in which anonymous participants agree to electronic informed consent forms on the app. It also exclusively uses an application-based platform to acquire individualized digital phenotypic data. We expect to collect clinical, biological, and digital phenotypic data centered on mood and anxiety symptoms, and we propose a possible model of centralized and decentralized research design.

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IntroductionThe role of digital therapeutics (DTx) in the effective management of attention deficit/hyperactivity disorder (ADHD) is beginning to gain clinical attention. Therefore, it is essential to verify their potential efficacy.MethodWe aimed to investigate the improvement in the clinical symptoms of ADHD by using DTx AimDT01 (NUROW) (AIMMED Co., Ltd., Seoul, Korea) specialized in executive functions. NUROW, which consists of Go/No-go Task- and N-Back/Updating-based training modules and a personalized adaptive algorithm system that adjusts the difficulty level according to the user’s performance, was implemented on 30 Korean children with ADHD aged 6 to 12 years. The children were instructed to use the DTx for 15 min daily for 4 weeks. The Comprehensive attention test (CAT) and Childhood Behavior Checklist (CBCL) were used to assess the children at baseline and endpoint. In contrast, the ADHD-Rating Scale (ARS) and PsyToolkit were used weekly and followed up at 1 month, for any sustained effect. Repeated measures ANOVA was used to identify differences between the participants during visits, while t-tests and Wilcoxon signed-rank tests were used to identify changes before and after the DTx.ResultsWe included 27 participants with ADHD in this analysis. The ARS inattention (F = 4.080, p = 0.010), hyperactivity (F = 5.998. p < 0.001), and sum (F = 5.902, p < 0.001) significantly improved. After applying NUROW, internalized (t = −3.557, p = 0.001, 95% CI = −3.682-−0.985), other (Z = −3.434, p = 0.001, effect size = −0.661), and sum scores (t = −3.081, p = 0.005, 95% CI = −10.126-−2.022) were significantly changed in the CBCL. The overall effect was confirmed in the ARS sustained effect analysis even after 1 month of discontinuing the DTx intervention.DiscussionAccording to caregivers, the findings indicate that DTx holds potential effect as an adjunctive treatment in children with ADHD, especially in subjective clinical symptoms. Future studies will require detailed development and application targeting specific clinical domains using DTx with sufficient sample sizes.Clinical trial registration: KCT0007579.