Anticholinergic and benzodiazepine medication use and risk of incident dementia: a UK cohort study

BMC Geriatrics

卷:19

Carol Brayne¹  Noll Campbell²  Malaz Boustani³  Phyo Kyaw Myint⁴  Louise Robinson⁵  Fiona E. Matthews⁵  Yoon K. Loke⁶  Nicholas Steel⁶  Chris Fox⁶  George M. Savva⁷  Antony Arthur⁷  Carlota M. Grossi⁷  Kathryn Richardson⁷  Ian Maidment⁸ 

[1] Cambridge Institute of Public Health, University of Cambridge;

[2] Department of Pharmacy Practice, College of Pharmacy, Purdue University;

[3] Indiana University School of Medicine;

[4] Institute of Applied Health Sciences, University of Aberdeen;

[5] Institute of Health and Society/Institute for Ageing, Newcastle University;

[6] Norwich Medical School, University of East Anglia;

[7] School of Health Sciences, University of East Anglia;

[8] School of Life and Health Sciences, Aston University;

关键词: Alzheimer disease;    Cognition;    Dementia;    Cohort study;    Benzodiazepines;    Cholinergic antagonists;   

DOI  :  10.1186/s12877-019-1280-2

来源: DOAJ

【 摘 要 】

Abstract Background Studies suggest that anticholinergic medication or benzodiazepine use could increase dementia risk. We tested this hypothesis using data from a UK cohort study. Methods We used data from the baseline (Y0), 2-year (Y2) and 10-year (Y10) waves of the Medical Research Council Cognitive Function and Ageing Study. Participants without dementia at Y2 were included (n = 8216). Use of benzodiazepines (including nonbenzodiazepine Z-drugs), anticholinergics with score 3 (ACB3) and anticholinergics with score 1 or 2 (ACB12) according to the Anticholinergic Cognitive Burden scale were coded as ever use (use at Y0 or Y2), recurrent use (Y0 and Y2), new use (Y2, but not Y0) or discontinued use (Y0, but not Y2). The outcome was incident dementia by Y10. Incidence rate ratios (IRR) were estimated using Poisson regression adjusted for potential confounders. Pre-planned subgroup analyses were conducted by age, sex and Y2 Mini-Mental State Examination (MMSE) score. Results Dementia incidence was 9.3% (N = 220 cases) between Y2 and Y10. The adjusted IRRs (95%CI) of developing dementia were 1.06 (0.72, 1.60), 1.28 (0.82, 2.00) and 0.89 (0.68, 1.17) for benzodiazepines, ACB3 and ACB12 ever-users compared with non-users. For recurrent users the respective IRRs were 1.30 (0.79, 2.14), 1.68 (1.00, 2.82) and 0.95 (0.71, 1.28). ACB3 ever-use was associated with dementia among those with Y2 MMSE> 25 (IRR = 2.28 [1.32–3.92]), but not if Y2 MMSE≤25 (IRR = 0.94 [0.51–1.73]). Conclusions Neither benzodiazepines nor ACB12 medications were associated with dementia. Recurrent use of ACB3 anticholinergics was associated with dementia, particularly in those with good baseline cognitive function. The long-term prescribing of anticholinergics should be avoided in older people.

【 授权许可】

Unknown