Uncertain Association Between Benzodiazepine Use and the Risk of Dementia: A Cohort Study
- Title
- Uncertain Association Between Benzodiazepine Use and the Risk of Dementia: A Cohort Study
- Author
- 정지은
- Keywords
- Dementia; benzodiazepine; cohort studies; propensity score
- Issue Date
- 2020-02
- Publisher
- ELSEVIER SCIENCE INC
- Citation
- JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, v. 21, no. 2, page. 201-211
- Abstract
- Objective: To examine the association between benzodiazepine use and the risk of dementia.
Design, setting, and participants: We conducted a retrospective cohort study, using a nationwide healthcare database of South Korea (2002-2016). The participants included new users of benzodiazepines aged ˃= 50 years, with no prior prescription record of benzodiazepines or a history of dementia within the previous 5 years (2002-2006).
Methods: Outcome was defined as an incident dementia with specified algorithms using diagnosis and prescription records, with the application of a 5-year lag-time following the index date during which outcomes were censored. We used a multivariable Cox proportional hazard model to estimate hazard ratio (HR) and the 95% confidence interval (CI). Comorbidities and comedications were treated as time-varying covariates in 90-day windows, and an active comparator was used to reduce potential bias from confounding by indication. Active comparators were defined as new-users of antidepressants.
Results: Our final participants included 616,256 patients, after propensity score estimation and matching on a 1:1 ratio. We observed a 23% increase in the risk of dementia in benzodiazepine users, compared with that in nonusers, over a mean follow-up period of 5.5 years (HR 1.23, 95% CI 1.14-1.32). A consistent finding was observed when the lag-time duration was extended to 7 years, revealing a close to association (HR 1.17, 95% CI 1.04-1.30). When new-users of antidepressants were used as the active comparator, no increase in the risk of dementia with benzodiazepines was observed over 7 years (HR 1.01, 95% CI 0.81-1.27).
Conclusions and implications: A significant association was observed between benzodiazepine use and the risk of dementia, compared with nonusers. However, a or negative association was observed with the use of the active comparator, suggesting the absence of a causal association between dementia and benzodiazepine use. (C) 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
- URI
- https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S1525861019306334?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1525861019306334%3Fshowall%3Dtrue&referrer=https:%2F%2Fwww.scopus.com%2Frecord%2Fdisplay.uri%3Feid%3D2-s2.0-85074512114%26origin%3Dinward%26txGid%3Dd8771c9c5150e72edf75094b81a7d09fhttps://repository.hanyang.ac.kr/handle/20.500.11754/163191
- ISSN
- 1525-8610
- DOI
- 10.1016/j.jamda.2019.08.017
- Appears in Collections:
- COLLEGE OF PHARMACY[E](약학대학) > PHARMACY(약학과) > Articles
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