In a retrospective cohort study of 72,496 older adults (65 years or older), benzodiazepines and anxiety disorders were associated with increased risk for dementia, but when patients had anxiety disorders, the use of benzodiazepines was not associated with additional dementia risk. “Further research is warranted to determine if benzodiazepines are associated with a reduced or increased risk for dementia compared to other anxiolytic medications in patients with anxiety disorders,” the authors conclude.
The predominantly White (85.6%) population was 59.9% women with a mean age of 74.1 ± 7.1 years when the study began in 2012. They were free of dementia and took no medications associated with cognitive impairment during 2012 and 2013. Follow-up began on an index date of Jan. 1, 2014. Anxiety disorder was a composite of generalized anxiety disorder, anxiety not otherwise specified, panic disorder, and social phobia.
“Six percent of eligible patients had an anxiety diagnosis and 3.6% received sustained benzodiazepine prescriptions [at least 2 separate prescription orders in any 6-month period],” the authors report. “There were 6,640 (9.2%) incident dementia events. After controlling for confounders, both sustained benzodiazepine use (HR 1.28, 95% CI: 1.11–1.47) and a diagnosis of anxiety (HR 1.19, 95% CI: 1.06–1.33) were associated with incident dementia in patients aged 65–75. Anxiety disorder with sustained benzodiazepine, compared to anxiety disorder alone, was not associated with incident dementia (HR 1.18, 95% CI: 0.92–1.51) after controlling for confounding. Results were not significant when limiting the sample to those ≥75 years of age.”