title: Regular Benzodiazepine and Z-Substance Use and Risk of Dementia: An Analysis of German Claims Data.
abstract: While 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.
  
  
  
  To evaluate the association between regular BDZR use and incident any dementia in a large German claims data set.
  
  
  
  Using 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.
  
  
  
  The 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.
  
  
  
  The restricted use of BDZRs may contribute to dementia prevention in the elderly.
authors: German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
authors: Willy
authors: W
authors: Gomm
authors: German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
authors: Klaus
authors: K
authors: von Holt
authors: German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
authors: Friederike
authors: F
authors: Thomé
authors: Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany.
authors: Karl
authors: K
authors: Broich
authors: German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.|Department of Psychiatry, University of Bonn, Bonn, Germany.
authors: Wolfgang
authors: W
authors: Maier
authors: Department of General Practice and Family Medicine, University of Bonn, Bonn, Germany.
authors: Klaus
authors: K
authors: Weckbecker
authors: German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.|Rostock Center for the Study of Demographic Change, Rostock, Germany.
authors: Anne
authors: A
authors: Fink
authors: German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.|Rostock Center for the Study of Demographic Change, Rostock, Germany.|Max-Planck-Institute for Demographic Research, Rostock, Germany.|Institute for Sociology and Demography, University of Rostock, Rostock, Germany.
authors: Gabriele
authors: G
authors: Doblhammer
authors: German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
authors: Britta
authors: B
authors: Haenisch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001569:Benzodiazepines / Q000009:adverse effects* / Q000737:chemistry; D016022:Case-Control Studies; D003704:Dementia / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology*; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007344:Insurance Claim Reporting / Q000706:statistics & numerical data / Q000639:trends*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D001569:Benzodiazepines
keywords: Benzodiazepines; dementia; elderly; risk factor; z-substances