The Incidence of Benzodiazepine and Related Drug Use in Persons with and without Alzheimer’s Disease

Background.Antihypertensive drug use is inconsistently associated with the risk of dementia, Alzheimer’s disease, cognitive impairment, and cognitive decline. Therefore, we conducted a meta-analysis of available prospective cohort studies to summarize the evidence on the strength of these relationships.Methods.Three electronic databases including MedLine, Embase, and the Cochrane Library were searched to identify studies from inception to April 2017. Only prospective cohort studies that reported effect estimates with corresponding 95% confidence intervals (CIs) of dementia, Alzheimer’s disease, cognitive impairment, and cognitive decline for antihypertensive drug use versus not using antihypertensive drugs were included.Results.We included 10 prospective cohort studies reporting data on 30,895 individuals. Overall, participants who received antihypertensive drugs had lower incidence of dementia (relative risk [RR]: 0.86; 95% CI: 0.75–0.99;p=0.033), while there was no significant effect on the incidence of Alzheimer’s disease (RR: 0.83; 95% CI: 0.64–1.09;p=0.154), cognitive impairment (RR: 0.89; 95% CI: 0.57–1.38;p=0.596), and cognitive decline (RR: 1.11; 95% CI: 0.86–1.43;p=0.415). Further, the incidence of Alzheimer’s disease might be affected by antihypertensive drug use in participants with specific characteristics.Conclusions.Antihypertensive drug use was associated with a significantly reduced risk of dementia, but not with the risk of Alzheimer’s disease, cognitive impairment, and cognitive decline.

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Drug Use Patterns of Persons with Alzheimer's Disease and Related Disorders Living in the Community

Journal of the American Geriatrics Society ◽

10.1111/j.1532-5415.1993.tb06949.x ◽

1993 ◽

Vol 41 (4) ◽

pp. 408-413 ◽

Cited By ~ 29

Author(s):

Todd P. Semla ◽

Donna Cohen ◽

Gregory Paveza ◽

Carl Eisdorfer ◽

Philip Gorelick ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Drug Use ◽

Use Patterns ◽

Drug Use Patterns

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Automated multi-dose dispensing in persons with and without Alzheimer’s disease—impacts on pharmacotherapy

European Journal of Clinical Pharmacology ◽

10.1007/s00228-021-03258-y ◽

2021 ◽

Author(s):

Sanna Vallius ◽

Heidi Taipale ◽

Marjaana Koponen ◽

Anna-Maija Tolppanen ◽

Antti Tanskanen ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Drug Use ◽

Community Dwelling ◽

Point Prevalence ◽

Study Cohort ◽

Before And After ◽

Benzodiazepine Use ◽

Inflammatory Drugs ◽

Anti Inflammatory

Abstract Purpose We investigated the drug use before and after transition to automated multi-dose dispensing (MDD) service among persons with Alzheimer’s disease (AD) and compared whether the changes were similar in persons without AD. Methods The register-based Finnish nationwide MEDALZ cohort includes 70,718 community-dwelling persons diagnosed with AD during 2005–2011. Each person who initiated MDD was matched in both groups with a comparison person without MDD by age, gender and for persons with AD, also time since AD diagnosis at the start of MDD. The study cohort included 15,604 persons with AD in MDD and 15,604 no-MDD, and 5224 persons without AD in MDD and 5224 no-MDD. Point prevalence of drug use was assessed every 3 months, from 1 year before to 2 years after the start of MDD and compared between persons in MDD to those who did not have MDD. Results MDD was started on average 2.9 (SD 2.1) years after AD diagnosis. At the start of MDD, the prevalence of drug use increased especially for antipsychotics, antidepressants, opioids, paracetamol and use of ≥ 10 drugs among persons with and without AD. Prevalence of benzodiazepine use (from 12% 12 months before to 17% at start of MDD), memantine (from 29 to 46%) and ≥ 3 psychotropics (from 3.2 to 6.0%) increased among persons with AD. Decreasing trend was observed for benzodiazepine-related drugs, urinary antispasmodics and non-steroidal anti-inflammatory drugs. Conclusion MDD seems to be initiated when use of psychotropics is initiated and the number of drugs increases.

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Dementia Care in Diverse Older Adults in the U.S. Deep South and the Rest of the United States

Journal of Alzheimer s Disease ◽

10.3233/jad-210240 ◽

2021 ◽

pp. 1-13

Author(s):

Maria Pisu ◽

Roy C. Martin ◽

Liang Shan ◽

Giovanna Pilonieta ◽

Richard E. Kennedy ◽

...

Keyword(s):

United States ◽

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Drug Use ◽

Ethnic Groups ◽

The United States ◽

Deep South ◽

Racial Ethnic ◽

The U.S

Background: Use of specialists and recommended drugs has beneficial effects for older adults living with Alzheimer’s disease and related dementia (ADRD). Gaps in care may exist for minorities, e.g., Blacks, and especially in the United States (U.S.) Deep South (DS), a poor U.S. region with rising ADRD cases and minority overrepresentation. Currently, we have little understanding of ADRD care utilization in diverse populations in this region and elsewhere in the U.S. (non-DS), and the factors that adversely impact it. Objective: To examine utilization of specialists and ADRD drugs (outcomes) in racial/ethnic groups of older adults with ADRD and the personal or context-level factors affecting these outcomes in DS and non-DS. Methods: We obtained outcomes and personal-level covariates from claims for 127,512 Medicare beneficiaries with ADRD in 2013–2015, and combined county-level data in exploratory factor analysis to define context-level covariates. Adjusted analyses tested significant association of outcomes with Black/White race and other factors in DS and non-DS. Results: Across racial/ethnic groups, 33%–43% in DS and 43%–50% in non-DS used specialists; 47%–55% in DS and 41%–48% in non-DS used ADRD drugs. In adjusted analyses, differences between Blacks and Whites were not significant. Vascular dementia, comorbidities, poverty, and context-level factor “Availability of Medical Resources” were associated with specialist use; Alzheimer’s disease and senile dementia, comorbidities, and specialist use were associated with drug use. In non-DS only, other individual, context-level covariates were associated with the outcomes. Conclusion: We did not observe significant gaps in ADRD care in DS and non-DS; however, research should further examine determinants of low specialist and drug use in these regions.

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Discussion 6

International Psychogeriatrics ◽

10.1017/s1041610200007195 ◽

2000 ◽

Vol 12 (S1) ◽

pp. 313-315

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Drug Use ◽

Previous Trial ◽

Increased Risk

Data presented by Dr. Allain indicated that benzodiazepines are associated with an increased risk of Alzheimer's disease (AD). Dr. Cohen asked whether any mechanism had been proposed for this finding. “No mechanism was proposed by the investigators,” said Dr. Allain. He noted that the investigators in this study, which has now enrolled more than 5,000 patients, are analyzing drug use among patients before and during the study. He also pointed out that the finding of an association between benzodiazepines and AD contrasts with the results of a previous trial, which found no such association.

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