title: Association between high cumulative dose of benzodiazepine in Chinese patients and risk of dementia: a preliminary retrospective case-control study.
abstract: BACKGROUND
  Evidence describing the association between high-dose benzodiazepine use and dementia has been conflicting. Most previous studies involved Caucasian populations, with only limited data on Chinese subjects. Possible differences exist between Chinese and Caucasian populations with regard to metabolism and prescription practice. This study aimed to assess the association between high-dose benzodiazepine use and dementia in a Chinese population.
  
  
  METHODS
  A retrospective case-control study was carried out in all public hospitals under the Hong Kong Hospital Authority Hong Kong West Cluster between 2000 and 2015. The study recruited 273 Chinese adults (91 cases, 182 controls) aged 75 and over, with at least 6 years of follow-up data. Each dementia case was matched with two controls according to sex, age group, and duration of follow-up. The number of patients with benzodiazepine ever-use and the exposure density based on the prescribed daily doses were assessed. Prescribed daily doses were categorized as either <1096 or ≥1096. Odds ratios and 95% confidence intervals were computed by multivariate analysis.
  
  
  RESULTS
  The difference in exposure density between the dementia and control groups was statistically significant between prescribed daily doses <1096 and ≥1096 (P = 0.02). There were two multivariate analyses models; one factored in depression (model 1), and the other (model 2) did not. Model 2 showed a statistically significant association (odds ratio = 1.71, 95% confidence intervals = 1.02-2.89, P = 0.04) between benzodiazepine exposure density and dementia.
  
  
  CONCLUSIONS
  High-dose benzodiazepine use may be associated with dementia in the Chinese population. Prospective studies are required.
authors.affiliation: Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong.|Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong.
authors.forename: Tsz-Tai
authors.identifier: http://orcid.org/0000-0002-4198-6668
authors.initials: TT
authors.lastname: Chan
authors.affiliation: Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong.|Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong.
authors.forename: William Chun-Yin
authors.initials: WC
authors.lastname: Leung
authors.affiliation: Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong.|Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong.
authors.forename: Victor
authors.initials: V
authors.lastname: Li
authors.affiliation: Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong.|Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong.
authors.forename: Kin-Yiu Wesley
authors.initials: KW
authors.lastname: Wong
authors.affiliation: Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong.|Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong.
authors.forename: Wing-Ming
authors.initials: WM
authors.lastname: Chu
authors.affiliation: Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong.|Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong.
authors.forename: Ka-Chun
authors.initials: KC
authors.lastname: Leung
authors.affiliation: Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong.|Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong.
authors.forename: Yuey-Zhun
authors.initials: YZ
authors.lastname: Ng
authors.affiliation: Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong.|Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong.
authors.forename: Yuen-Ming Gary
authors.initials: YG
authors.lastname: Kai
authors.affiliation: Division of Geriatrics, Department of Medicine, Queen Mary Hospital, Hong Kong.
authors.forename: Yat-Fung
authors.initials: YF
authors.lastname: Shea
authors.affiliation: Division of Neurology, Department of Medicine, Queen Mary Hospital, Hong Kong.
authors.forename: Shek-Kwan Richard
authors.initials: SR
authors.lastname: Chang
authors.affiliation: Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.|Alzheimer's Disease Research Network, The University of Hong Kong, Hong Kong.
authors.forename: Leung-Wing
authors.initials: LW
authors.lastname: Chu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000139:chemically induced* / Q000453:epidemiology; D044466:Asian People; D001569:Benzodiazepines / Q000008:administration & dosage* / Q000009:adverse effects*; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D003704:Dementia / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D001569:Benzodiazepines
keywords: Chinese; benzodiazepine; dementia