苯二氮䓬类药物、精神药物与痴呆：一项基于人群的队列研究。
Benzodiazepine, psychotropic medication, and dementia: A population-based cohort study.
机构信息
Inserm Research Center for Epidemiology and Biostatistics (U897) - Team Neuroepidemiology, Bordeaux, France; University of Bordeaux, Bordeaux, France.
Inserm Research Center for Epidemiology and Biostatistics (U897) - Team Neuroepidemiology, Bordeaux, France.
出版信息
Alzheimers Dement. 2016 May;12(5):604-13. doi: 10.1016/j.jalz.2015.10.006. Epub 2015 Nov 18.
INTRODUCTION
Benzodiazepine use has been associated with increased risk of dementia. However, it remains unclear whether the risk relates to short or long half-life benzodiazepines and whether it extends to other psychotropic drugs.
METHODS
Prospective cohort study among 8240 individuals ≥65, interviewed on medication use. Incident dementia confirmed by an end point committee after a multistep procedure.
RESULTS
During a mean of 8 years of follow-up, 830 incident dementia cases were observed. Users of benzodiazepines at baseline had a 10% increased risk of dementia (adjusted hazard ratio [HR], 1.10; 95% confidence interval, 0.90-1.34). However, long half-life (>20 hours) benzodiazepine users had a marked increased risk of dementia (HR = 1.62; 1.11-2.37) compared with short half-life users (HR = 1.05; 0.85-1.30). Users of psychotropics had an increased risk of dementia (HR = 1.47; 1.16-1.86).
DISCUSSION
Results of this large, prospective study show increased risk of dementia for long half-life benzodiazepine and psychotropic use.
简介
苯二氮䓬类药物的使用与痴呆风险增加有关。然而，目前尚不清楚这种风险与半衰期较短或较长的苯二氮䓬类药物有关，也不清楚这种风险是否会扩展到其他精神药物。
方法
这是一项在 8240 名年龄在 65 岁及以上的个体中进行的前瞻性队列研究，在研究中对他们的用药情况进行了访谈。通过多步程序，由终点委员会确认痴呆的发病情况。
结果
在平均 8 年的随访期间，观察到 830 例新发痴呆病例。基线时使用苯二氮䓬类药物的患者痴呆风险增加 10%（调整后的危险比 [HR]，1.10；95%置信区间，0.90-1.34）。然而，与半衰期较短的患者（HR=1.05；0.85-1.30）相比，半衰期较长（>20 小时）的苯二氮䓬类药物使用者痴呆风险显著增加（HR=1.62；1.11-2.37）。使用精神药物的患者痴呆风险也增加（HR=1.47；1.16-1.86）。
讨论
这项大型前瞻性研究的结果表明，长半衰期苯二氮䓬类药物和精神药物的使用与痴呆风险增加有关。
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