Use of benzodiazepines in the elderly to treat anxiety and insomnia is not associated with an increased risk of dementia, a study has found.
However, the paper published in The BMJ said doctors were still advised to avoid prescribing benzodiazepines to older adults to prevent adverse outcomes, withdrawal and dependence.
The researchers from the University of Washington and Group Health in Seattle said the results did not support a causal link between benzodiazepine use and dementia.
Previous studies have produced conflicting results on the question of whether the class of drugs could be associated with an increased risk of dementia.
The US study involved 3,434 patients aged 65 and older without dementia, who were followed for an average of seven years.
Cognitive screening was carried out when the patients entered the study and every subsequent two years. Benzodiazepine use was assessed using pharmacy data.
During follow-up, 797 (23 per cent) patients developed dementia, of whom 637 (80 per cent) developed Alzheimer’s.
The researchers found no association between the highest level of drug use — the median level was equivalent to one year of daily use — and dementia or cognitive decline.
They found a small increased risk of dementia in people with low (up to one month) and moderate (one-to-four months) of use. However, the authors suggested this use could represent treatment of prodromal symptoms.
“Our results do not support a causal association between benzodiazepine use and dementia,” they said.
Given the mixed evidence regarding benzodiazepines and dementia, and the fact that the drug was associated with adverse events, they said “healthcare providers are still advised to avoid benzodiazepines in older adults”.
BMJ 2016; online February 2, doi: http://dx.doi.org/10.1136/bmj.i90
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