מילות מפתח: Benzodiazepines, Non-benzodiazepine GABA agonists, Z-drugs, Dementia

רקע מדעי ומטרה:

Benzodiazepines (BZDs) and non-benzodiazepine GABA agonists (N-BZDAs; also known as “Z-drugs”) are frequently prescribed by family doctors. Alongside their desired clinical benefits, these drugs are associated with a broad spectrum of adverse effects. Previous studies about the association between BZDs or N-BZDAs and dementia risk have yielded conflicting findings.

שיטות:

In this historical cohort study, 997,242 adults aged 40-69 years were followed for a median period of 16 years. Individuals diagnosed with dementia within the initial five years of follow-up were excluded. The association between the use of BZDs or N-BZDAs and dementia incidence was assessed, accounting for various potential sociodemographic and clinical confounders.

תוצאות:

Throughout the follow-up period, 35,283 cases (3.5%) of dementia were diagnosed. Cohort members who sporadically used BZDs or N-BZDAs at baseline exhibited a higher propensity for developing dementia compared to non-users (adjusted hazard ratio 1.14, 95% confidence interval 1.11-1.18). Chronic usage was associated with an even greater risk (adjusted hazard ratio 1.34, 95% confidence interval 1.27-1.41), suggestive of a dose-response relationship. These findings were consistent across multiple BZDs and remained robust through various sensitivity analyses.

מסקנות:

This population-based, real-world cohort study demonstrates a clinically meaningful association between the use of BZDs or N-BZDAs and the incidence of dementia.

חשיבות לרפואת המשפחה:

Family doctors should integrate this evidence into the shared decision-making process, and consider safer alternatives to benzodiazepines where feasible.