Do Benzodiazepine Drugs “Cause” Dementia?
Benzodiazepine drugs include Lorazepam (Ativan), alprazolam (Xanax), diazepam (Valium), clonazepam (Klonopin), and temazepam (Restoril). A recent study published in the British Medical Journal (BMJ) concludes that new use of benzodiazepines was associated with increased risk of dementia in older adults (age>65). This article has garnished some publicity as benzodiazepines are commonly prescribed medications. It is important to note the study published in the BMJ does not prove benzodiazepines “cause” dementia, but rather a link exits between benzodiazepine use and dementia. This may lead to multiple questions regarding benzodiazepine use and what does cause dementia? Or what risk factors are associated with dementia?
Benzodiazepines are listed on the BEERs list published by the American Geriatric Society of potentially inappropriate medications if used in older adults. This expert panel states all benzodiazepines increase the risk of cognitive impairment, delirium, falls, fractures, and motor vehicle accidents in older patients. Also medications including benzodiazepines are a known risk factor for delirium, especially in older adults, that may lead to increased confusion. The study in BMJ provides additional evidence that benzodiazepines should be used at the lowest dose for the shortest duration, especially in older adults.
The Alzheimer’s Association states the three most important risk factors for developing Alzheimer’s or dementia are age, genetics, and family history. While these risk factors can’t be changed there are several additional risk factors that can be influenced such as alcohol use, high blood pressure, heart disease, high cholesterol, depression, diabetes, obesity, and smoking. Current evidence points towards healthy living as your best strategy to reduce the risk of developing dementia. The Alzheimer’s association at www.alz.org is a great reference for current evidence and strategies to reduce your lifestyle risk factors.
The American Geriatrics Society 2012 Beers Criteria Update Expert Panel. AGS updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2012; DOI: 10.1111/j.1532-5415.2012.03923.x.
Alzheimer’s Association at www.alz.org
Matthew Palmer PharmD, CGP
AlixaRx Clinical Pharmacist
Dr. Palmer is a Clinical Pharmacist for AlixaRx. He provides clinical consulting services to skilled nursing facilities in the southern Wisconsin area. Matt is a certified geriatric pharmacist with over 9 years experience in the Long-term care arena. He also serves on the Senior and Long-term Care Section Board for the Pharmacy Society of Wisconsin and is a Clinical Instructor for the University of Wisconsin School of Pharmacy. Matt has a Bachelors of Science from the University of Wisconsin – La Crosse and a Doctor of Pharmacy degree from the University of Wisconsin – Madison.