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O4‐05‐03: Chronic use of benzodiazepines and cognitive decline
Author(s) -
Mura Thibault,
Proustlima Cecile,
JacqminGadda Hélène,
Akbaraly Tasnime,
Dartigues JeanFrancois,
BarbergerGateau Pascale,
Tzourio Christophe,
Berr Claudine
Publication year - 2011
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2011.05.1999
Subject(s) - cognitive decline , cognition , psychology , population , neuropsychology , effects of sleep deprivation on cognitive performance , clinical psychology , cognitive test , neuropsychological test , medicine , psychiatry , gerontology , dementia , environmental health , disease
Background: In the elderly, benzodiazepines use concerns 10 to 20% of the population. To date, three prospective studies have investigated the association between chronic use of benzodiazepines and cognitive decline, and gave conflicting results. The interpretation of these studies is limited by a qualitative statistical analysis (decline or not). We aimed to examine whether the long-term use of benzodiazepine is associated with an accelerated decline of cognitive performances by using a recent published statistical model adapted tomultivariate, longitudinal, nonGaussian quantitative outcomes. Thismodel allowed us to study change over time of the latent common cognitive factor underlying several psychometric tests considered simultaneously and measured repeatedly.Methods:Data came from thewell knownmulticentric prospective Three Cities study in which 5,196 participants from three cities in France (Bordeaux, Montpellier and Dijon) aged 65 years or older were followed-up during 7 years. At each examination phase (baseline, 2, 4 and 7 years), the use of benzodiazepine was collected by a face-to-face interview, and cognitive functioningwas assessed by trained neuropsychologists. Cognitive declinewas analyzed using a nonlinearmultivariatemodelwith latent process for longitudinal data. Latent cognitive factor was constructed from five neuropsychological tests outcomes:MMSE, Isaacs Set test, BentonVisual Retention Test, and the Trail Making Test (A and B). Analyses were adjusted for center, gender, education, socio-professional status, depression, insomnia, high blood pressure, hypercholesterolemia, alcohol, tobacco consumption and physical activity.Results: In the present study, 969 chronic users reported taking benzodiazepine during 2, 4 or 7 consecutive years (Cognitive datawere taken into account only for consecutiveyears of use or nouse). The chronic use of benzodiazepines was significantly associated with a low cognitive latent level (ß1⁄4 1,80 SE1⁄4 0,26 p1⁄4< 0,001). No association was found between chronic use and anacceleration of cognitive decline, neitheron latent cognitive factor (ß*(year after 65)21⁄4 0,10 SE1⁄4 0.10 p1⁄4 0,34), nor on specific psychometric tests (figure1).Conclusions: By showing a cross sectional association between use of benzodiazepines and cognition, but no association with accelerated cognitive decline, we evidenced that chronic use of benzodiazepines is not a risk factor of cognitive decline in free-dementia elderly population.