Faculty of Medicine, University of Porto, Porto, Portugal.
Faculty of Medicine, CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal.
Eur Geriatr Med. 2022 Feb;13(1):19-32. doi: 10.1007/s41999-021-00553-w. Epub 2021 Aug 17.
Benzodiazepines (BZDs) and related drugs (BZRDs) are commonly used to treat diverse psychiatric disorders due to their anxiolytic, hypnotic and sedative properties, despite their known associated side effects, including acute consequences on cognition. Recently, some studies have also suggested that long-term cognitive effects may coexist, as the increased risk of cognitive decline and dementia. This review aims to appraise and summarise published synthesis studies on the risk of dementia development due to BZDs/BZRDs use.
A comprehensive systematic search was carried out in PubMed, Web of Science, Cochrane Library and Epistemonikos databases. Grey literature and hand search of the studies' reference lists were undertaken. Meta-analysis, systematic and non-systematic reviews were included. Neither language nor date restrictions were applied. Search results other than synthesis studies were excluded. The methodological quality of the included reviews was analysed with AMSTAR-2 and SANRA tools.
Overall, 877 records were initially retrieved and 15 complied with the inclusion criteria. From these, five were systematic reviews with meta-analysis, two were systematic reviews and eight were non-systematic reviews. Most of the primary studies included in the analysed reviews found an association between BZDs/BZRDs use and subsequent dementia, with meta-analysis studies reporting an increased risk for users (ORs ranging from 1.38 to 1.78). However, the considerable clinical and methodological heterogeneity of the primary studies makes it difficult to establish a causal relationship.
Although hampered by the heterogeneity between the studies, the present findings suggest an association between BZDs/BZRDs use and increased risk of dementia in older adults.
苯二氮䓬类药物（BZDs）和相关药物（BZRDs）由于其抗焦虑、催眠和镇静作用，常用于治疗各种精神疾病，尽管已知其存在相关副作用，包括对认知功能的急性影响。最近，一些研究还表明，长期认知影响可能并存，因为认知能力下降和痴呆的风险增加。本综述旨在评估和总结已发表的关于 BZDs/BZRDs 使用与痴呆发展风险的综合研究。
在 PubMed、Web of Science、Cochrane Library 和 Epistemonikos 数据库中进行了全面的系统检索。还进行了灰色文献和研究参考文献的手工检索。纳入了荟萃分析、系统综述和非系统综述。未对语言和日期进行限制。排除了非综合研究的检索结果。使用 AMSTAR-2 和 SANRA 工具分析了纳入综述的方法学质量。
共检索到 877 条记录，其中 15 条符合纳入标准。其中，5 项为系统综述与荟萃分析，2 项为系统综述，8 项为非系统综述。分析中综述纳入的大多数原始研究发现 BZDs/BZRDs 使用与随后的痴呆之间存在关联，荟萃分析研究报告使用者的风险增加（比值比范围为 1.38 至 1.78）。然而，原始研究的临床和方法学异质性很大，难以确定因果关系。
尽管受到研究间异质性的限制，但目前的研究结果表明，BZDs/BZRDs 使用与老年人痴呆风险增加之间存在关联。
