Study Roundup: Can Anti-anxiety Medications Cause Dementia in Older People?
A study in the British Medical Association's journal BMJ found that use of a particular anti-anxiety medication raised their risk of dementia in some patients.
Benzodiazepines are a class of drugs frequently prescribed to treat anxiety, panic attacks, insomnia, and other conditions including alcohol dependence and seizures.
Introduced in the 1960s, they offered a relatively safe replacement for barbiturates. Appropriately prescribed, benzodiazepines continue to be safe. However, evidence increasingly suggests that long-term use in older patients can lead to serious side effects.
A study recently published in the British Medical Association’s journal BMJ found that long-term use of benzodiazepines in patients 65 and older is associated with a 50 percent increase in the risk of developing dementia compared to people not taking these drugs.
The research is part of the highly-regarded PAQUID cohort, a study group of 3,777 older inhabitants of southwestern France.
The Expert Take
Dr. Tobias Kurth, lead researcher of the study and Director of Research at the French National Institute of Health, spoke with Healthline about the results.
“The most important of our findings is that compared to non-users of benzodiazepines, people 65 and older who receive long-term treatment with these medications have a 50 percent greater chance of developing Alzheimer’s type dementia within the following 15 years,” he said.
Dr. Kurth said the increased risk carries the potential for significant social and economic impact.
“In France, the increased risk would correspond to several thousand cases of dementia per year,” he said. “It is important to note, though, that the increased risk is observed only in long-term users of benzodiazepines. It is unlikely that treatment lasting just days to a few weeks could increase dementia risk.”
Dr. Bernard Bégaud of the University of Bordeaux, a co-author of the study, emphasizes that the findings do not mean that doctors should stop prescribing benzodiazepines.
“They remain useful drugs for the management of insomnia and anxiety, but are only indicated for treatment lasting between two and four weeks,” he said. “Long-term treatments should be maintained only if fully justified.”
Source and Method
The study, based at the Victor Segalen campus of the University of Bordeaux, observed 1,063 participants from the PAQUID panel of seniors from southwestern France.
Neuropsychologists systematically assessed dementia during face-to-face interviews, spaced out over time, with the 1,063 study participants, some of whom were taking benzodiazepines. The neuropsychologists did not know that the researchers were looking for an association between benzodiazepines and increased dementia risk.
The study was published Sept. 27, 2012 .
A 2005 study in the journal Psychological Medicine assessed six prior studies done on this topic. The results were inclusive, with some past studies showing decreased, and others increased occurrence of dementia in association with use of benzodiazepines.
A 2008 study published in the American Neurological Association’s Annals of Neurology showed that many symptoms of incipient Alzheimer’s—among them, insomnia, depression, and anxiety—match conditions for which benzodiazepines are prescribed. This created additional uncertainty as to whether benzodiazepines themselves correlated to increased risk of dementia.
The current study’s methodology was conceived to detect if dementia could verifiably be provoked by long-term benzodiazepine use better than previous studies. Though the study was rigorous and the findings robust, the researchers still caution that so-called reverse causation cannot be entirely ruled out as an alternative explanation of their findings.
- Scott Rose