Association between Development of Dementia and Use of Benzodiazepines: A Systematic Review and Meta‐Analysis
Tóm tắt
The use of benzodiazepines and the development of dementia is controversial, with studies indicating that benzodiazepines could be either a protective factor or a risk factor for dementia, or no association may exist between the two. Our objective was to identify whether such an association exists.
Systematic review and meta‐analysis of 12 prospective and retrospective cohort studies and case‐control studies.
A total of 981,133 (in the systematic review) and 980,860 (in the meta‐analysis) adults or elderly individuals.
A search of the PubMed,
Our results suggest an association between the use of benzodiazepines and the development of dementia. However, the current evidence lacks the power to infer differences between the effects of Alzheimer's disease and vascular dementias, long‐acting and short‐acting benzodiazepines, and various exposure loads (duration and dose). Future long‐term prospective cohort studies are necessary, with adequate adjustments for confounding variables, strategies to minimize reverse causality, reporting of subgroups aimed at greater homogeneity of findings, adequate statistical power to identify high‐magnitude effects, and defined daily dose analyses for dose‐response gradient.
Từ khóa
Tài liệu tham khảo
HigginsJ GreenS.Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0[updated March 2011]. The Cochrane Collaboration 2011.
MataBd LucchettaRC MastroianniP.Association between dementia and benzodiazepine use: systematic review and meta‐analysis–CRD4201705. PROSPERO 2017. Available fromhttp://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017056122. Accessed August 20 2018.
WellsG SheaB O'ConnellD et al.The Newcastle‐Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta‐analyses 2013. Available fromhttps://cran.r-project.org/web/packages/readr/readr.pdf. Accessed October 6 2016.
Team RC, 2011, R: a language and environment for statistical computing
WickhamH HesterJ FrançoisR.Readr: read rectangular tet data. R package version 1.1.1 2017. Available fromhttps://cran.r-project.org/package=readr. Accessed August 20 2018.
Schwarzer G, 2007, Meta: an R package for meta‐analysis, R News, 7, 40
Fiorelli K, 2015, A prescrição de benzodiazepínicos no Brasil: uma análise da literatura, ABCs Heal Sci Cs, 40, 184
By the American Geriatrics Society 2015 Beers Criteria Update Expert Panel, American Geriatrics Society 2015 updated Beers criteria for potentially inappropriate medication use in older adults, J Am Geriatr Soc 2015, 63, 2227, 10.1111/jgs.13702