• Willy Gomm, Klaus von Holt, Friederike Thomé, Karl Broich, Wolfgang Maier, Klaus Weckbecker, Anne Fink, Gabriele Doblhammer, and Britta Haenisch.
• German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
• J. Alzheimers Dis. 2016 Sep 6; 54 (2): 801-8.

BackgroundWhile acute detrimental effects of benzodiazepine (BDZ), and BDZ and related z-substance (BDZR) use on cognition and memory are known, the association of BDZR use and risk of dementia in the elderly is controversially discussed. Previous studies on cohort or claims data mostly show an increased risk for dementia with the use of BDZs or BDZRs. For Germany, analyses on large population-based data sets are missing.ObjectiveTo evaluate the association between regular BDZR use and incident any dementia in a large German claims data set.MethodsUsing longitudinal German public health insurance data from 2004 to 2011 we analyzed the association between regular BDZR use (versus no BDZR use) and incident dementia in a case-control design. We examined patient samples aged≥60 years that were free of dementia at baseline. To address potential protopathic bias we introduced a lag time between BDZR prescription and dementia diagnosis. Odds ratios were calculated applying conditional logistic regression, adjusted for potential confounding factors such as comorbidities and polypharmacy.ResultsThe regular use of BDZRs was associated with a significant increased risk of incident dementia for patients aged≥60 years (adjusted odds ratio [OR] 1.21, 95% confidence interval [CI] 1.13-1.29). The association was slightly stronger for long-acting substances than for short-acting ones. A trend for increased risk for dementia with higher exposure was observed.ConclusionThe restricted use of BDZRs may contribute to dementia prevention in the elderly.

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