Benzodiazepines and antidepressants: Effects on cognitive and functional decline in Alzheimer's disease and Lewy body dementia.
| Title: | Benzodiazepines and antidepressants: Effects on cognitive and functional decline in Alzheimer's disease and Lewy body dementia. |
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| Authors: | Borda MG; Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.; Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia.; Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.; Jaramillo-Jimenez A; Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.; Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.; Grupo de Neurociencias de Antioquia, Medical School, Universidad de Antioquia, Medellin, Colombia.; Oesterhus R; Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.; Department of Clinical Medicine, University of Bergen, Bergen, Norway.; Santacruz JM; Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia.; Cognition and Memory Center, Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia.; Psychiatry Department, Hospital Universitario San Ignacio, Bogotá, Colombia.; Tovar-Rios DA; Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.; School of Statistics, Faculty of Engineering, Universidad Del Valle, Santiago de Cali, Colombia.; Department of Mathematics and Statistics, Faculty of Basic Sciences, Universidad Autónoma de Occidente, Santiago de Cali, Colombia.; Soennesyn H; Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.; Cano-Gutierrez CA; Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia.; Geriatric Unit, Hospital Universitario San Ignacio, Bogotá, Colombia.; Vik-Mo AO; Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.; Department of Clinical Medicine, University of Bergen, Bergen, Norway.; Aarsland D; Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.; Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK. |
| Source: | International journal of geriatric psychiatry [Int J Geriatr Psychiatry] 2021 Jun; Vol. 36 (6), pp. 917-925. Date of Electronic Publication: 2021 Jan 16. |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: John Wiley Country of Publication: England NLM ID: 8710629 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1099-1166 (Electronic) Linking ISSN: 08856230 NLM ISO Abbreviation: Int J Geriatr Psychiatry Subsets: MEDLINE |
| Imprint Name(s): | Publication: Chichester : John Wiley; Original Publication: Chichester, Sussex, England ; [New York] : Wiley, c1986- |
| MeSH Terms: | Alzheimer Disease*/drug therapy ; Lewy Body Disease*/drug therapy; Antidepressive Agents/therapeutic use ; Benzodiazepines/adverse effects ; Norway/epidemiology ; Aged ; Cognition ; Cohort Studies ; Humans |
| Abstract: | Objectives: We aim to study the effects of the prescription of benzodiazepines and antidepressants on cognitive and functional decline in older adults living with Alzheimer's disease (AD) and Lewy body dementia (LBD) over a 5-year follow-up.; Methods: This is a longitudinal analysis of a Norwegian cohort study entitled "The Dementia Study of Western Norway" (DemVest). We included 196 patients newly diagnosed with AD (n = 111) and LBD (n = 85), followed annually for 5 years. Three prescription groups were defined: only benzodiazepines (BZD), only antidepressants (ADep), and the combination of benzodiazepines and antidepressants (BZD-ADep). Linear mixed-effects models were conducted to analyze the effect of the defined groups on the outcomes. The outcomes were functional decline, measured by the Rapid Disability Rating Scale-2, and cognition measured with the Mini-Mental State Examination.; Results: Prescription of the combination of benzodiazepines and antidepressants in LBD was associated with faster functional decline. In AD, the prescription of BZD and BZD-ADep was associated with greater functional deterioration. ADep alone did not show positive or negative significant associations with the studied outcomes.; Conclusions: BZD and especially the combination of BZD and ADep are associated with functional decline in AD and LBD and should be used cautiously.; (© 2021 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.) |
| References: | Orgeta V , Mukadam N , Sommerlad A , Livingston G . The lancet commission on dementia prevention, intervention, and care: a call for action. Ir J Psychol Med. 2019;36(2):85-88.; Alzheimer’s-Association. Alzheimer's Disease facts and figures. Alzheimers Dement. 2020;16(2):391+.; Mueller C , Ballard C , Corbett A , Aarsland D . The prognosis of dementia with Lewy bodies. Lancet Neurol. 2017;16(5):390-398.; Rongve A , Soennesyn H , Skogseth R , et al. Cognitive decline in dementia with Lewy bodies: a 5-year prospective cohort study. BMJ Open. 2016;6:e010357.; Borda MG , Soennesyn H , Steves CJ , Osland Vik-Mo A , Pérez-Zepeda MU , Aarsland D . Frailty in older adults with mild dementia: dementia with Lewy bodies and Alzheimer’s disease. Dementia Geriatric Cognitive Disord Extra. 2019;9(1):176-183.; McKeith IG , Boeve BF , Dickson DW , et al. Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB Consortium. Neurology. 2017;89(1):88-100.; Reuben DB , Rubenstein LV , Hirsch SH , Hays RD . Value of functional status as a predictor of mortality: results of a prospective study. Am J Med. 1992;93(6):663-669.; Bierman AS . Functional status: the six vital sign. J general Intern Med. 2001;16(11):785-786.; Wilberforce M , Challis D , Davies L , Kelly MP , Roberts C , Loynes N . Person-centredness in the care of older adults: a systematic review of questionnaire-based scales and their measurement properties. BMC Geriatr. 2016;16(1):63.; Bjoerke-Bertheussen BB , Bjoerke-Bertheussen J , Ehrt U , Rongve A , Ballard C , Aarsland D . Neuropsychiatric symptoms in mild dementia with Lewy bodies and Alzheimer’s disease. Dementia Geriatric Cognitive Disord. 2012;34(1):1-6.; Vik-Mo AO , Giil LM , Borda MG , Ballard C , Aarsland D . The individual course of neuropsychiatric symptoms in people with Alzheimer's and Lewy body dementia: 12-year longitudinal cohort study. Br J Psychiatry. 2019;216(1):43-48. https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/individual-course-of-neuropsychiatric-symptoms-in-people-with-alzheimers-and-lewy-body-dementia-12year-longitudinal-cohort-study/03170C0BD3CE227967FB7E8D296AC9D0.; Rongve A , Vossius C , Nore S , Testad I , Aarsland D . Time until nursing home admission in people with mild dementia: comparison of dementia with Lewy bodies and Alzheimer's dementia. Int J Geriatr Psychiatry. 2014;29(4):392-398.; Svendsboe E , Terum T , Testad I , et al. Caregiver burden in family carers of people with dementia with Lewy bodies and Alzheimer's disease. Int J Geriatr Psychiatry. 2016;31(9):1075-1083.; Schmitz A . Benzodiazepines: the time for systematic change is now. Addiction. 2020. https://doi.org/10.1111/add.15095.; Parikh C . Antidepressants in the elderly: challenges for study design and their interpretation. Br J Clin Pharmacol. 2000;49(6):539-547.; Ford AH , Almeida OP . Management of depression in patients with dementia: is pharmacological treatment justified? Drugs Aging. 2017;34(2):89-95.; Hasan SS , Zaidi STR , Nirwan JS , et al. Use of central nervous system (CNS) medicines in aged care homes: a systematic review and meta-analysis. J Clin Med. 2019;8(9):1292.; Brandt J , Leong C . Benzodiazepines and Z-drugs: an updated review of major adverse outcomes reported on in epidemiologic research. Drugs R. 2017;17(4):493-507.; Patorno E , Glynn RJ , Levin R , Huybrechts KF . Benzodiazepines and the risk of all-cause mortality in older patients. Innov Aging. 2018;2(Suppl 1):852-853.; Hessmann P , Dodel R , Baum E , et al. Prescription of benzodiazepines and related drugs in patients with mild cognitive deficits and Alzheimer’s disease. Pharmacopsychiatry. 2019;52(02):84-91.; Alexopoulos GS . Depression in the elderly. Lancet. 2005;365(9475):1961-1970.; Neutel CI , Skurtveit S , Berg C . What is the point of guidelines? Benzodiazepine and z-hypnotic use by an elderly population. Sleep Med. 2012;13(7):893-897.; Fride Tvete I , Bjørner T , Skomedal T . Risk factors for excessive benzodiazepine use in a working age population: a nationwide 5-year survey in Norway. Scand J Prim Health Care. 2015;33(4):252-259.; Oesterhus R , Aarsland D , Soennesyn H , Rongve A , Selbaek G , Kjosavik SR . Potentially inappropriate medications and drug-drug interactions in home-dwelling people with mild dementia. Int J Geriatr Psychiatry. 2017;32(2):183-192.; Dyer AH , Murphy C , Lawlor B , Kennelly SP . Cognitive outcomes of long-term benzodiazepine and related drug (BDZR) use in people living with mild to moderate Alzheimer's disease: results from NILVAD. J Am Med Dir Assoc. 2020;21(2):194-200.; Baek YH , Lee H , Kim WJ , et al. Uncertain association between benzodiazepine use and the risk of dementia: a cohort study. J Am Med Dir Assoc. 2020;21(2):201-211:e202.; Aarsland D , Rongve A , Nore SP , et al. Frequency and case identification of dementia with Lewy bodies using the revised consensus criteria. Dement Geriatr Cogn Disord. 2008;26(5):445-452.; Vik-Mo AO , Giil LM , Ballard C , Aarsland D . Course of neuropsychiatric symptoms in dementia: 5-year longitudinal study. Int J Geriatr Psychiatry. 2018;33(10):1361-1369.; McKhann G , Drachman D , Folstein M , Katzman R , Price D , Stadlan EM . Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA work group under the auspices of department of health and human services Task force on Alzheimer's disease. Neurology. 1984;34(7):939-944.; Emre M , Aarsland D , Brown R , et al. Clinical diagnostic criteria for dementia associated with Parkinson's disease. Mov Disord. 2007;22(12):1689-1707.quiz 1837.; Skogseth R , Hortobagyi T , Soennesyn H , et al. Accuracy of clinical diagnosis of dementia with Lewy bodies versus neuropathology. J Alzheimers Dis. 2017;59(4):1139-1152.; WHO. Collaborating Centre for Drug Statistics Methodology; 2014. https://www.fhi.no/en/hn/drug/who-collaborating-centre-for-drug-statistics-methodology/.; Helseinformatikk Norsk. Ferdigheter I Dagliglivet - RDRS-2. 2020. https://nhi.no/skjema-og-kalkulatorer/skjema/geriatripleie/ferdigheter-i-dagliglivet-rdrs-2/.; Linn MW . Rapid disability rating scale-2 (RDRS-2). Psychopharmacol Bull. 1988;24(4):799-780.; Borda MG , Aarsland D , Tovar-Rios DA , et al. Neuropsychiatric symptoms and functional decline in Alzheimer's disease and Lewy body dementia. J Am Geriatr Soc. 2020.; Borda MG , Jaramillo-Jimenez A , Tovar-Rios DA , et al. Hippocampal subfields and decline in activities of daily living in Alzheimer's disease and dementia with Lewy bodies. Neurodegener Dis Manag. 2020.; Folstein MF , Folstein SE , McHugh PR . Mini-Mental State" A practical method for grading the cognitive state of patients for the clinician. J Psychiatric Res. 1975;12:189-198.; Linn BS , Linn MW , Gurel L . Cumulative illness rating scale. J Am Geriatr Soc. 1968;16(5):622-626.; Cummings JL , Mega M , Gray K , Rosenberg-Thompson S , Carusi DA , Gornbein J . The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994;44(12):2308-2314.; Røen I , Selbaek G , Kirkevold Ø , Engedal K , Lerdal A , Bergh S . The reliability and validity of the Norwegian version of the quality of life in late-stage dementia scale. Dement Geriatr Cogn Disord. 2015;40(3-4):233-242.; Scarmeas N , Brandt J , Albert M , et al. Delusions and hallucinations are associated with worse outcome in Alzheimer disease. Arch Neurol. 2005;62(10):1601-1608.; Griffin CE, 3rd , Kaye AM , Bueno FR , Kaye AD . Benzodiazepine pharmacology and central nervous system-mediated effects. Ochsner J. 2013;13(2):214-223.; Martin P . Coadministration benzodiazepine and antidepressant drugs: the state of art. Encephale. 2006;32(5 Pt 1):753-766.; Ogawa Y , Takeshima N , Hayasaka Y , et al. Antidepressants plus benzodiazepines for adults with major depression. Cochrane Database Syst Rev. 2019;6(6):1-65. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001026.pub2/full.; Fulone I , Silva MT , Lopes LC . Long-term benzodiazepine use in patients taking antidepressants in a public health setting in Brazil: a cross-sectional study. BMJ Open. 2018;8(4):e018956.; Demyttenaere K , Bonnewyn A , Bruffaerts R , et al. Clinical factors influencing the prescription of antidepressants and benzodiazepines: results from the European study of the epidemiology of mental disorders (ESEMeD). J Affect Disord. 2008;110(1-2):84-93.; Tien SC , Chan HY , Hsu CC . The factors associated with inappropriate prescription patterns of benzodiazepines and related drugs among patients with dementia. Psychogeriatrics. 2020.20(4):447-457. https://onlinelibrary.wiley.com/doi/full/10.1111/psyg.12527.; American geriatrics society 2015 updated beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015;63(11):2227-2246. https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/jgs.13702.; Billioti de Gage S , Pariente A , Bégaud B . Is there really a link between benzodiazepine use and the risk of dementia?. Expert Opin Drug Saf. 2015;14(5):733-747.; Pariente A , de Gage SB , Moore N , Bégaud B . The benzodiazepine-dementia disorders link: current state of knowledge. CNS Drugs. 2016;30(1):1-7.; Mitchell A . Cognitive Screening Instruments: A Practical Approach. In: The mini-mental state examination (MMSE): update on its diagnostic accuracy and clinical utility for cognitive disorders. Cham, Switzerland: Springer International Publishing; 2016. https://doi.org/10.1007/978-3-319-44775-9.; Kok RM , Reynolds CF, 3rd . Management of depression in older adults: a review. JAMA. 2017;317(20):2114-2122.; Nishtala PS , Chyou T-y . Zopiclone use and risk of fractures in older people: population-based study. J Am Med Dir Assoc. 2017;18(4):368.e361-368.e368.; You SC , Walsh CM , Chiodo LA , Ketelle R , Miller BL , Kramer JH . Neuropsychiatric symptoms predict functional status in Alzheimer's disease. J Alzheimers Dis. 2015;48(3):863-869.; Mallo SC , Patten SB , Ismail Z , et al. Does the neuropsychiatric inventory predict progression from mild cognitive impairment to dementia? A systematic review and meta-analysis. Ageing Res Rev. 2020;58:101004.; Tseng LY , Huang ST , Peng LN , Chen LK , Hsiao FY . Benzodiazepines, z-hypnotics, and risk of dementia: special considerations of half-lives and concomitant use. Neurotherapeutics. 2020;17(1):156-164. |
| Grant Information: | United Kingdom DH_ Department of Health |
| Contributed Indexing: | Keywords: Alzheimer's disease; Antidepressive Agents; Lewy body dementia; activities of daily living; benzodiazepines; cognitive decline; dementia; functional disability; hypnotics and sedatives |
| Substance Nomenclature: | 0 (Antidepressive Agents); 12794-10-4 (Benzodiazepines) |
| Entry Date(s): | Date Created: 20201231 Date Completed: 20210602 Latest Revision: 20210602 |
| Update Code: | 20260130 |
| DOI: | 10.1002/gps.5494 |
| PMID: | 33382911 |
| Database: | MEDLINE |
Journal Article; Research Support, Non-U.S. Gov't