Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-27T08:41:58.259Z Has data issue: false hasContentIssue false
  • English
  • Français

Associations between Benzodiazepine Use and Neuropsychological Test Scores in Older Adults*

Published online by Cambridge University Press:  19 March 2015

Edward Helmes  and
Truls Østbye
Edward Helmes*
Affiliation:
James Cook University
Truls Østbye
Affiliation:
Duke Global Health Institute
*
†La correspondance et les demandes de tirés-à-part doivent être adressées à: / Correspondence and requests for offprints should be sent to: Dr. Edward Helmes Department of Psychology James Cook University Townsville Qld 4811 Australia ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Benzodiazepines are widely prescribed for anxiety, although use of this class of medications has been associated with dependency and cognitive changes. This article describes the study in which we investigated the relationship between the class of benzodiazepine available for use and associated performance on neuropsychological tests in a community sample of 1,754 older Canadians from the Canadian Study of Health and Aging. Benzodiazepines were classified as short-, intermediate-, and long-acting. Associations were calculated between each class of benzodiazepine and eight neuropsychological measures, using multiple regression analysis and controlling for demographic variables. Results showed different effects of the co-variates across the three drug classes, and short half-life benzodiazepines were not associated with any neuropsychological measure. Intermediate half-life and long half-life benzodiazepine use were each associated with two measures. Increased focus on specific domains of cognitive function is needed to improve our understanding of how benzodiazepine use influences cognition.

Résumé

Les benzodiazépines sont largement prescrits pour l'anxiété, bien que l'utilisation de cette classe de médicaments fût associée à la dépendance et les changements cognitifs. Cet article décrit une étude dans laquelle j'ai examiné la relation entre une* classe des benzodiazépines disponibles pour l'utilisation et le rendement lié aux tests neuro-psychologiques dans un échantillon de communauté de 1 754 Canadiens âgés de l'Etude canadienne sur la santé et le vieillissement. Les benzodiazépines ont été classés comme ayant une action de courte durée, intermédiare ou longue. À l'aide d'une analyse de régression multiple, et tenant compte de variables démographiques, les associations ont été calculées entre chaque catégorie de benzodiazépine et huit mesures neuro-psychologiques. Les résultats ont révélé des effets différents au sein des classes des trois médicaments; les benzodiazépines avec une courte demi-vie n'etaient associées à aucune mesure neuro-psychologique. Chacune des benzodiazépines à demi-vie intermédiare et à longue demi-vie ont été associée à deux mesures. Afin d'améliorer notre compréhension de la façon dont l'utilisation des benzodiazépines influence la cognition, une concentration accrue sur des domaines spécifiques de la fonction cognitive est requise.

Keywords

agingbenzodiazepinesmemoryolder adultsvieillissmentbenzodiazépinesmémoireadultes plus âgés
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 34 , Issue 2 , June 2015 , pp. 207 - 214
Copyright
Copyright © Canadian Association on Gerontology 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Sincere thanks to Simon Crowe for inspiring the analyses. Core funding for Phases 1 & 2 of the CSHA was provided by the Seniors’ Independence Research Program, through Health Canada’s NHRDP. Funding for analysis of the caregiver component was provided by the Medical Research Council. Additional funding was provided by Pfizer Canada Inc. through the MRC/PMAC, NHRDP, by Bayer Inc., and by the B.C. Health Research Foundation. Core funding for Phase 3 was provided by the CIHR. Supplementary funding for the caregiver component was obtained from CIHR. Additional funding was provided by Merck-Frosst and by Jansen-Ortho. CSHA was coordinated through the University of Ottawa and Health Canada.

References

American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed. - revised), Author: Washington, DC.Google Scholar
Barker, M. J., Greenwood, K. M., Jackson, M., & Crowe, S. F. (2004). Persistence of cognitive efects after withdrawal from long-term benzodiazepine use: A meta-analysis. Archives of Clinical Neuropsychology, 19, 437–454.Google Scholar
Barker, M. J., Greenwood, K. M., Jackson, M., & Crowe, S. F. (2005). An evaluation of persisting cognitive effects after withdrawal from long-term benzodiazepine use. Journal of the International Neuropsychological Society, 11, 281–289.CrossRefGoogle ScholarPubMed
Billioti de Gage, S., Begaud, B., BAzin, F., Verdowx, H., Dartigues, J.-F., Peres, K., et al. (2012). Benzodiazepine use and risk of dementia: Prospective population-based study. British Medical Journal, 345, e6231.Google Scholar
Canadian Study of Health and Aging Working Group. (1994). Canadian Study of Health and Aging: Study methods and prevalence of dementia. Canadian Medical Association Journal, 150, 899–913.Google Scholar
Crowe, S. F., & Barker, M. J. (2007). Benzodiazepines. In Kalechstein, A. & Van Gorp, W. G. (Eds.), Neuropsychology and substance use: State-of-the-art and future directions (pp. 75–110). New York, NY: Taylor & Francis.Google Scholar
Dubois, S., Bédard, M., & Weaver, B. (2008). The impact of benzodiazepines on safe driving. Traffic Injury Prevention, 9, 404–413.Google Scholar
Egan, M., Moride, Y., Wolfson, C., & Monette, J. (2000). Long term continuous use of benzodiazepines by older adults in Quebec: Prevalence, incidence and risk factors. Journal of the American Geriatrics Society, 48, 811–816.Google Scholar
Gray, S. L., Eggen, A. E., Blough, D., Buchner, D., & LaCroix, A. Z. (2003). Benzodiazepine use in older adults enrolled in a health maintenance organization. The American Journal of Geriatric Psychiatry, 11, 568–576.CrossRefGoogle Scholar
Gray, S. L., LaCroix, A. Z., Hanlon, J. T., Penninx, B. W. J. H., Blough, D. K., Leveille, S. G., et al. (2006). Benzodiazepine use and physical disability in community-dwelling older adults. Journal of the American Geriatrics Society, 54, 224–230.Google Scholar
Hanlon, J. T., Horner, R. D., Schmader, K. E., Fillenbaum, G. G., Lewis, I. K., Wall, W. E., et al. (1998). Benzodiazepine use and cognitive function among community-dwelling elderly. Clinical Pharmacolgy & Therapeutics, 64, 684–692.Google Scholar
Harwood, D. G., Kalechstein, A., & Sultzer, D. L. (2007). Substance use and neuropsychological disorders in aging. In Kalechstein, A. & Van Gorp, W. G. (Eds.), Neuropsychology and substance use: State-of-the-art and future directions (pp. 323–348). New York, NY: Taylor & Francis.Google Scholar
Helmes, E., Østbye, T., & Steenhuis, R. E. (2011). Incremental contribution of reported previous head injury to the prediction of diagnosis of dementia and cognitive functioning in older adults. Brain Injury, 25, 338–347.Google Scholar
Hogan, D. B., Maxwell, C. J., Fung, T. S., & Ebly, E. M. (2003). Prevalence and potential consequences of benzodiazepine use in senior citizens: Results from the Canadian Study of Health and Aging. Canadian Journal of Clinical Pharmacology, 10, 72–77.Google Scholar
Llorente, M. D., David, D., Golden, A. G., & Silverman, M. A. (2000). Defining patterns of benzodiazepine use in older adults. Journal of Geriatric Psychiatry and Neurology, 13, 150–160.CrossRefGoogle ScholarPubMed
Mamdani, M., Rapoport, M., Shulman, K. I., Herrmann, N., & Rochon, P. A. (2005). Mental health-related drug utilization among older adults: Prevalence, trends, and costs. The American Journal of Geriatric Psychiatry, 13, 892–900.Google Scholar
McAndrews, M. P., Weiss, R. T., Sandor, P., Taylor, A., Carlen, P. L., & Shapiro, C. M. (2003). Cognitive effects of long-term benzodiazepine use in older adults. Human Psychopharmacology: Clinical and Experimental, 18, 51–57.Google Scholar
Neutel, I. (1998). Benzodiazepine-related traffic accidents in young and elderly drivers. Human Psychopharmacology: Clinical and Experimental, Special Issue: Drugs and Driving, 13, S115–S123.Google Scholar
Préville, M., Bosse, C., Vasiliadis, H.-M., Voyer, P., Laurier, C., & Berbiche, D. (2012). Correlates of potentially inappropriate prescriptions of benzodiazepines among older adults: Results from the ESA Study. Canadian Journal on Aging, 31, 313–322.Google Scholar
Runci, S. J., Redman, J. R., & O’Connor, D. W. (2005). Language use of older Italian-background persons with dementia in mainstream and ethno-specific residential care. International Psychogeriatrics, 17, 699–708.Google Scholar
Starr, J. M., McGurn, B., Whiteman, M., Pattie, A., Whalley, L. J., & Deary, I. J. (2004). Life long changes in cognitive ability are associated with prescribed medications in old age. International Journal of Geriatric Psychiatry, 19, 327–332.Google Scholar
Stowell, K. R., Chang, C. C., Bilt, J., Stoehr, G. P., & Ganguli, M. (2008). Sustained benzodiazepine use in a community sample of older adults. Journal of the American Geriatrics Society, 56, 2285–2291.Google Scholar
Tannenbaum, C., Paquette, A., Hilmer, S., Holroyd-Leduc, J., & Carnahan, R. (2012). A systematic review of amnestic and non-amnestic cognitive impairment induced by antichholinergic, antihistamine, GABAergic and opioid drugs. Drugs and Aging, 29, 639–658.Google Scholar
Thomas, R. E. (1998). Benzodizepine use and motor vehicle accidents: Systematic review of reported association. Canadian Family Physician, 44, 799–808.Google Scholar
Tuokko, H. A., Frerichs, R. J., & Kristjansson, B. (2001). Cognitive impairment, no dementia: Concepts and issues. International Psychogeriatrics, 13, 183–202.CrossRefGoogle ScholarPubMed
Tuokko, H., Kristjansson, E., & Miller, J. (1995). Neuropsychological detection of dementia: An overview of the neuropsychological component of the Canadian Study of Health and Aging. Journal of Clinical and Experimental Neuropsychology, 17, 352–373.Google Scholar
Verhaeghe, W., Mets, T., & Corne, L. (1996). Benzodiazepine use among elderly patients presenting at the emergency room. Archives of Gerontology and Geriatrics, 22, 55–62.Google Scholar
Voyer, P., Cappeliez, P., Perodeau, G., & Préville, M. (2005). Mental health for older adults and benzodiazepine use. Journal of Community Health Nursing, 22, 213–229.CrossRefGoogle Scholar
Walop, W., & Semenchuk, M. (2002). Coding of drugs used by respondents of the Canadian Study of Health and Aging. Canadian Journal of Clinical Pharmacology, 9, 64–68.Google Scholar