Cognitive effects of long‐term benzodiazepine use in older adults

Abstract

This study examined the potential for cognitive morbidity associated with the long-term use of benzodiazepine (BZ) sedative-hypnotics in a sample of healthy older adults. Tests of memory, attention and processing speed were conducted prior to and 1 month after drug discontinuation for 25 BZ-users and at similar intervals for 26 healthy control subjects. After controlling for differences in affective status between BZ-users and controls, there were no significant group differences in cognitive performance. However, BZ-users showed greater gains on tests of attention and speed of processing at repeat testing compared with controls this improvement was not attributable to a change in affective status. These findings suggest that there may be subtle and reversible effects of long-term BZ use on speed-dependent tasks in older adults. However, the magnitude of these effects is quite small and may be of little clinical significance in the healthy elderly.

The effect of chronic benzodiazepine use on cognitive functioning in older persons: good, bad or indifferent?

“…The results of the Fastbom et al (1998) study may have been biased because BZ was no longer given to subjects with emerging dementia, which may explain why subjects who were still on BZs at the end of the study had a lower risk of dementia (Greenblatt et al, 1989). The Pat McAndrews et al (2003) study suffered from a very high drop-out, which might have led to selective loss of those most seriously cognitively impaired. Furthermore, they defined chronic BZ use as 6-month BZ use, which might have been too short a period for classification as chronic use.…”

Elderly and drugs: risks and necessity of rational use

“…Cognitive impairments indisputably occur with the acute administration of benzodiazepines, but the studies differ over the extent of cognitive impairments amongst long-term users. Some studies state continued cognitive difficulties with chronic use (Hanlon et al, 1998), whereas others report only modest impairments amongst healthy long-term users (McAndrews et al, 2003). Some evidence also suggests that chronic benzodiazepine use is linked to subsequent development of dementia (Paterniti et al, 2002).…”

The basic pharmacoepidemiology of benzodiazepine use in Norway 2004-9

“…The drugs may also impair cognitive abilities, and this can be especially negative among those elderly patients who already have more marginal cognitive function (6,7). However, others have found the negative effects on cognitive function to be marginal (8,9). Taken alone in high doses or, more usually, together with other intoxicants, benzodiazepines may also be abused.…”