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减少苯二氮䓬类药物使用对未来痴呆负担的影响。

Impact of benzodiazepine consumption reduction on future burden of dementia.

机构信息

INSERM, ISPED, Bordeaux Population Health Research Center, UMR 1219, Univ. Bordeaux, Bordeaux, France.

Pole de Santé Publique, Service de Pharmacologie Médicale, CHU de Bordeaux, 33000, Bordeaux, France.

出版信息

Sci Rep. 2020 Sep 4;10(1):14666. doi: 10.1038/s41598-020-71482-0.

Abstract

Dementia is a major public health issue worldwide and chronic use of benzodiazepine, which is very frequent in northern countries, was found to be a risk factor of dementia. This work aims at evaluating the impact of a reduction in chronic use of benzodiazepine on the future burden of dementia in France. Using estimations of dementia incidence and of benzodiazepine use and nation-wide projections of mortality and population sizes, a Monte Carlo approach based on an illness-death model provided projections of several indicators of dementia burden. With no change in benzodiazepine consumption, the prevalence of dementia between age 65 and 99 in France in 2040 was estimated at 2.16 millions (95% confidence interval (CI) 1.93-2.38), with a life expectancy without dementia at 65 years equal to 25.0 years (24.7-25.3) for women and 23.8 years (23.5-24.2) for men. Assuming a disappearance of chronic use of benzodiazepine in 2020, the prevalence would be reduced by about 6.6% in 2040 and the life expectancy without dementia would increase by 0.99 (0.93-1.06) year among women and 0.56 (0.50-0.62) among men. To conclude, a modest but significant reduction in future dementia burden could be obtained by applying current recommendation for duration of benzodiazepine use.

摘要

痴呆症是全球范围内的一个主要公共卫生问题,而在北方国家非常普遍的苯二氮䓬类药物的长期使用被发现是痴呆症的一个风险因素。这项工作旨在评估减少苯二氮䓬类药物的慢性使用对法国未来痴呆症负担的影响。使用痴呆症发病率和苯二氮䓬类药物使用的估计值以及全国死亡率和人口规模的预测,基于疾病死亡模型的蒙特卡罗方法提供了痴呆症负担的几个指标的预测。如果苯二氮䓬类药物的使用没有变化,预计 2040 年法国 65 至 99 岁人群中痴呆症的患病率为 216 万(95%置信区间(CI)为 193-238),65 岁时无痴呆症的预期寿命女性为 25.0 岁(24.7-25.3),男性为 23.8 岁(23.5-24.2)。假设 2020 年消除慢性苯二氮䓬类药物的使用,那么到 2040 年,患病率将减少约 6.6%,女性无痴呆症的预期寿命将增加 0.99 岁(0.93-1.06),男性将增加 0.56 岁(0.50-0.62)。总之,通过应用当前关于苯二氮䓬类药物使用持续时间的建议,可以适度但显著地减少未来的痴呆症负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/789e/7474098/92cac0e46870/41598_2020_71482_Fig1_HTML.jpg

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