Batya Swift Yasgur, MA, LSW
Mortality rates in patients with AD who use BZDRs was 13.4 per 100 person-years, vs 8.5 per 100 person-years in nonusers during the 6-month study period (adjusted hazard ratio [HR], 1.4). The association was significant from initiation of use.
“I was surprised by how big the increased risk was,” lead author Laura K. Saarelainen, a PhD candidate at the Kuopio Research Center for Geriatric Care, University of Eastern Finland, told Medscape Medical News.
“We would like clinicians to know that these drugs have major adverse events from the very beginning of use,” she added.
The study was published online November 15 in the International Journal of Geriatric Psychiatry.
Individuals with AD are a “vulnerable population,” subject to a high frequency of chronic comorbidities, mortality, and the behavioral and psychological symptoms of dementia (BPSD), the authors write.
Although treatment guidelines recommend that BZDRs be used only as short-term or infrequent treatment of BPSDs, use of BZDRs “increases considerably” at the time of AD diagnosis, with almost one third of patients using these agents, the authors state.
Moreover, no previous studies have focused specifically on community-dwelling individuals with AD. The authors therefore aimed to study all-cause 180-day mortality in a nationwide cohort of community-dwelling persons with AD.
“We chose benzodiazepines for study because they have not received a great deal of previous research, and information about adverse effects is lacking,” Saarelainen said.
To investigate this issue, the researchers used data from the Medication Use and Alzheimer’s Disease cohort, which includes all community-dwelling persons diagnosed with mild to moderate AD in Finland between 2005 and 2011. Data were obtained from nationwide Finnish registers.
BZDRs were defined as benzodiazepines (anatomic therapeutic chemicals of classes N05BA and N05CD) and benzodiazepine-related drugs (“Z-drugs,” or drugs of class N05CF).
Benzodiazepines included in the study were diazepam, chlordiazepoxide, oxazepam, lorazepam, alprazolam, nitrazepam, temazepam. Z-drugs included zopiclone and zolpidem.
Link to article on Medscape: