Bourgeois Jolyce, Elseviers Monique M, Van Bortel Luc, Petrovic Mirko, Vander Stichele Robert H
Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium.
Hum Psychopharmacol. 2015 Mar;30(2):85-93. doi: 10.1002/hup.2456. Epub 2015 Jan 8.
Chronic use of benzodiazepines and Z-drugs (BZD/Zs) has been linked to cognitive decline. In this one-year prospective cohort study, we explored the impact of chronic BZD/Z use on cognitive decline compared to nonusers.
In cognitively capable BZD/Z users and nonusers in 10 Belgian nursing homes, we investigated cognition with the MiniMentalStateExamination(MMSE) at baseline and one year. A decrease of ≥ 4 points on the MMSE (clinically relevant decrease) was used in multiple logistic regression. We collected baseline demographics, functional, psychometric and social characteristics potentially influencing cognition.
In both the 131 BZD/Z users and 95 nonusers, the cognition decreased significantly over time, but without significant difference between the groups. Clinically relevant decrease was present in 34% BZD/Z users and 27% nonusers (NS). Controlled for age, gender, education and BZD/Z use, the significant risk factors for clinically relevant cognitive decline were depression, hearing and functional impairment. Frequent reading was associated with less MMSE decrease. Our findings could not demonstrate with statistical significance that BZD/Z use was associated with fast cognitive decline. The risk factors for fast decline were depression, hearing and functional impairment, and the absence of a reading attitude. In addition, BZD/Z use and depression were associated, indicating a complex relationship.
长期使用苯二氮䓬类药物和Z类药物（BZD/Zs）与认知功能下降有关。在这项为期一年的前瞻性队列研究中，我们探讨了与未使用者相比，长期使用BZD/Zs对认知功能下降的影响。
在比利时10家养老院中认知功能正常的BZD/Zs使用者和未使用者中，我们在基线和一年时用简易精神状态检查表（MMSE）对认知功能进行了调查。MMSE评分下降≥4分（具有临床意义的下降）被用于多因素逻辑回归分析。我们收集了可能影响认知功能的基线人口统计学、功能、心理测量和社会特征。
在131名BZD/Zs使用者和95名未使用者中，认知功能均随时间显著下降，但两组之间无显著差异。34%的BZD/Zs使用者和27%的未使用者出现了具有临床意义的下降（无统计学差异）。在控制了年龄、性别、教育程度和BZD/Zs使用情况后，具有临床意义的认知功能下降的显著危险因素是抑郁、听力和功能障碍。经常阅读与MMSE评分下降较少有关。我们的研究结果未能在统计学上证明使用BZD/Zs与快速认知功能下降有关。快速下降的危险因素是抑郁、听力和功能障碍，以及缺乏阅读习惯。此外，BZD/Zs的使用与抑郁有关，表明存在复杂的关系。
