Physicians and psychiatrists often prescribe benzodiazepines, such as Xanax or Valium, to help ease anxiety or encourage sleep. However, those working in senior care may want to reconsider their use for patients, according to recent research. A study by researchers from the University of Montreal and Université de Bordeaux and published in the BMJ found that use of these drugs may be related to a higher incidence of Alzheimer's disease.
Benzodiazepines and dementia
For the study, researchers looked at health records for 2,000 people over 65 with Alzheimer's and 7,000 without the disease, examining them for a history of using benzodiazepines within the last six years. Seniors with Alzheimer's were more likely to have used the drugs in the past, and those who had used them for the longest period had the highest risk. According to researchers, taking benzodiazepines for less than three months conferred no extra Alzheimer's risk, but participants who had used them for three to six months had nearly one-third greater chance of having the disease. After six months of use, the risk of developing Alzheimer's was 84 percent higher than it was for people who had never used the drugs.
Benzodiazepines that stayed in the system longer were shown to carry a greater risk than short-acting ones. Thus people taking drugs like Valium and Dalmane were more likely to have Alzheimer's than those taking Xanax or Restoril.
Causation is unclear
Although benzodiazepine users showed greater risk for dementia and its symptoms, such as confusion, researchers cautioned that they couldn't prove the medications were causing them. Confusion and short-term cognitive impairments can be side effects of the drugs, but whether these symptoms persist and possibly cause dementia is unknown. Dementia has been found to cause sleep difficulties and anxiety, according to the Harvard Health Blog, so the increased use of benzodiazepines before an Alzheimer's diagnosis may be a sign that symptoms are already present.
"Benzodiazepines are risky to use in older people because they can cause confusion and slow down mental processes. However, although there is an association, we still can't say that benzodiazepines actually cause Alzheimer's," Anne Fabiny, chief of geriatrics at Cambridge Health Alliance, told the Harvard Health Blog.
The American Geriatrics Society has already recommended avoiding benzodiazepines for the treatment of insomnia, agitation or delirium in older adults. Since seniors are more sensitive to the medications, due to lower metabolism, the drugs might make them more prone to cognitive impairment, according to the AGS.