Regular Benzodiazepine and Z-Substance Use and Risk of Dementia: An Analysis of German Claims Data

Gomm, Willy; Holt, Klaus von; Thomé, Friederike; Broich, Karl; Maier, Wolfgang; Weckbecker, Klaus; Fink, Anne; Doblhammer, Gabriele; Haenisch, Britta

doi:10.3233/jad-151006

Cited by 47 publications

(45 citation statements)

References 26 publications

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“…In most of the studies, the time lag in main analyses has been 1–2 years , and in one study 5 years . These studies have been inconsistent, with some claiming that BZDRs and BZDs are AD/dementia risk factors and others reporting no association . One, without any time lag reported that BZDs were associated with decreased risk of AD .…”

Section: Introductionmentioning

confidence: 99%

“…Studies on dose–response relationship of BZDs have been equally heterogeneous, with two studies showing a dose–response effect , one reporting an increased risk with smaller cumulative doses only , and one reporting null results . We are aware on only one study that assessed association between Z drugs and AD or vascular dementia, concluding with null results .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The risk of Alzheimer's disease associated with benzodiazepines and related drugs: a nested case–control study

Tapiainen

Taipale

Tanskanen

et al. 2018

Acta Psychiatr Scand

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Benzodiazepine and related drug use in general was associated with modestly increased risk of AD. No major differences were observed between different subcategories of BZDRs (i.e. benzodiazepines, Z drugs, short-/medium-acting or long-acting BZDRs). As dose-response relationship abolished after adjustment for other psychotropics, it is possible that the association may partially be due to antidepressants and/or antipsychotics, or concomitant use of these medications.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The risk of Alzheimer's disease associated with benzodiazepines and related drugs: a nested case–control study

Tapiainen

Taipale

Tanskanen

et al. 2018

Acta Psychiatr Scand

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“…All other studies focused on the association between BZD and dementia risk. Eight case control studies (Billioti de Gage et al, ; Chan et al, ; Gomm et al, ; Imfeld, Bodmer, Jick, & Meier, ; Takada, Fujimoto, & Hosomi, ; Tapiainen et al, ; C.‐S. Wu, Ting, Wang, Chang, & Lin, ; C.‐S.…”

Section: Resultsmentioning

confidence: 99%

Drug interactions with dementia‐related pathophysiological pathways worsen or prevent dementia

Barus

Béné

Deguil

et al. 2019

British J Pharmacology

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Many risk factors are known to induce or precipitate dementia. Drugs acting via different mechanisms can modulate cognitive performance and exert either beneficial or deleterious effects on cognition through functional or neuropathological mechanisms. This review discusses the association between several classes of drugs and cognitive impairment and dementia risk. These drugs can be divided into drugs targeting CNS disorders (e.g., anticholinergic drugs, antiepileptics, antipsychotics, benzodiazepines, and opioids) and drugs targeting non‐CNS disorders (e.g., antidiabetics, antihypertensives, proton pump inhibitors, and statins). Furthermore, we sought to highlight the pharmacological mechanisms underlying their possible detrimental or beneficial effects on cognition. Anticholinergic and antiepileptic drugs were excluded from this review because their effects on cognition are well known. Studies investigating benzodiazepines have revealed an increased risk of dementia. Conclusions on dementia risk or cognitive impairment regarding opioids and antipsychotic drugs are difficult to draw. These different classes appear to impair cognition not by a single clear mechanism of action specific to each class but by several relatively interdependent and interconnected mechanisms (e.g., impaired neurotransmission, neuroinflammation, neuronal death, oxidative stress, or interactions with dementia‐related pathways). The dementia risk initially associated with the use of proton pump inhibitors might have been overestimated. In contrast, statins, antihypertensive medications, and antidiabetics could potentially decrease the risk of dementia and cognitive impairment by acting in ways opposite to the mechanisms cited above. Linked Articles This article is part of a themed section on Therapeutics for Dementia and Alzheimer's Disease: New Directions for Precision Medicine. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.18/issuetoc

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“…The AOK covers about 50% of the German population at least 80 years old and one third of the total population at least 50 years old [20]. The AOK data set includes the ambulatory as well as the hospital sector of the health care system.…”

Section: Methodsmentioning

confidence: 99%

“…The covariates were selected based on existing evidence and previous publications on the topic of dementia risk and gout diagnoses [18, 20–22]. We considered comorbidity as present if it was reported in at least one quarter during the observation time, and in at least two quarters during the study time.…”

Section: Methodsmentioning

confidence: 99%

Hyperuricemia and dementia – a case-control study

et al. 2018

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BackgroundThere is evidence that uric acid may have antioxidant and neuroprotective effects and might therefore alter the risk for neurodegenerative diseases such as dementia. So far, the relation between serum uric acid (SUA) levels or hyperuricemia and dementia remains elusive. Most studies focused on the disease or SUA levels. Effects of anti-hyperuricemic treatment have not been considered yet. This study investigated the association between hyperuricemia and dementia taking into account anti-hyperuricemic treatment.MethodsWe used longitudinal German public health insurance data and analyzed the association between hyperuricemia with and without different treatment options and dementia in a case-control design. Applying logistic regression the analysis was adjusted for several potential confounders including various comorbidities and polypharmacy.ResultsWe identified 27,528 cases and 110,112 matched controls of which 22% had a diagnosis of hyperuricemia or gout and 17% received anti-hyperuricemic drugs. For patients with a diagnosis of hyperuricemia we found a slightly reduced risk for dementia (adjusted odds ratio [OR] 0.94, 95% confidence interval [CI] 0.89 to 0.98). The risk reduction was more pronounced for patients treated with anti-hyperuricemic drugs (adjusted OR 0.89, 95% CI 0.85 to 0.94, for regular treatment).ConclusionsOur results showed a slight reduction for dementia risk in patients with hyperuricemia, both with and without anti-hyperuricemic treatment.

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Regular Benzodiazepine and Z-Substance Use and Risk of Dementia: An Analysis of German Claims Data

Abstract: The restricted use of BDZRs may contribute to dementia prevention in the elderly.

Cited by 47 publications

References 26 publications

The risk of Alzheimer's disease associated with benzodiazepines and related drugs: a nested case–control study

The risk of Alzheimer's disease associated with benzodiazepines and related drugs: a nested case–control study

Drug interactions with dementia‐related pathophysiological pathways worsen or prevent dementia

Hyperuricemia and dementia – a case-control study

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