MedicalResearch.com Interview with:
Vesa Tapiainen, MD
School of Pharmacy, University of Eastern Finland
Research Centre for Comparative Effectiveness and Patient Safety
University of Eastern Finland Kuopio, Finland
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Alzheimer’s disease is a non-curable dementing disease and a major health concern and thus, identification of potential modifiable risk factors, such as benzodiazepines, is important. Benzodiazepines and related drugs are commonly used among older people as every fourth older people use them.
Benzodiazepines and related drugs were associated with modestly increased risk of Alzheimer’s disease. A dose-response relationship was observed with higher cumulative dose and longer use periods being associated with higher risk of Alzheimer’s disease. The risk associated with larger cumulative doses was partly explained by more common use of other psychotropics among these persons.
MedicalResearch.com: What should readers take away from your report?
Response: Even though the association between benzodiazepine use and Alzheimer’s disease was small in this study, threshold for prescribing these drugs should be high enough due to their overall adverse eﬀect proﬁle (such as higher risk of falls and hip fractures). These drugs are often used for treating sleep problems but their efficacy for this indication diminishes in weeks or months while the risks of adverse events remains. Therefore, the physicians should consider the risks and benefits, as well as appropriate duration of treatment before prescribing these drugs. On continuous use, the risks and benefits should be re-evaluated regularly. Further, targeting the causes of sleep problems and use of non-pharmacological treatments should be prioritized.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: It would be interesting to investigate the effect of other psychotropics and concomitant use of these psychotropics to risk of Alzheimer’s or cognitive decline in more detail. These kind of studies should use sufficient lag time between exposure and outcome in order to minimize the possibility of protopathic bias because these drugs are often used for prodromal symptoms of dementia.
Tapiainen, H. Taipale, A. Tanskanen, J. Tiihonen, S. Hartikainen, A.-M. Tolppanen. The risk of Alzheimer’s disease associated with benzodiazepines and related drugs: a nested case-control study. Acta Psychiatrica Scandinavica, 2018; 138 (2): 91 DOI: 10.1111/acps.12909
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