Affecting 36 million people worldwide, dementia is the main cause of dependency in older adults. Therefore, it is a major public health concern. Scientists project that population growth and aging will result in the number of affected individuals doubling every 20 years, reaching 115 million people in the year 2050. Since we currently lack treatment for this condition, researchers have begun to focus on preventative measures. Today, we’ll look at a study which analyzes a potential link between benzodiazepines and Alzheimer’s disease.
Understanding Key Terms
Before we begin, a few definitions:
Benzodiazepines are a class of drugs with sedative properties. They are primarily used to treat symptoms of anxiety or insomnia. Sometimes called “benzos,” these medications calm a person by raising levels of GABA (a neurotransmitter) in the brain. Popular benzodiazepines: alprazolam (Xanax), clonazepam (Klonopin), and diazepam (Valium).
Dementia is a general term referring to a person’s decline in mental ability. It describes a group of symptoms associated with this degeneration, including memory loss, misplacing things, forgetting appointments, difficulty with problem solving, struggling with familiar tasks, and confusion. Dementia is not a normal part of aging. It is caused by damage to brain cells.
Alzheimer’s is the most common cause of dementia. It is a specific, degenerative brain disease; dementia is a general condition. Alzheimer’s is caused by complex brain changes after cell damage, which lead to symptoms that worsen over time. Early symptoms include difficulty remembering information, but eventually, sufferers will become disoriented, confused, and change their behavior. The greatest known risk factor for Alzheimer’s is increasing age, but it should not be considered a normal part of aging. Researchers now believe that benzodiazepines may add to a person’s risk of developing this condition.
Benzodiazepines: Use Among Older Adults
A literature review from the Harvard Review of Psychiatry found that in spite of the many risks associated with benzodiazepines, their use was prevalent among older adults. Researchers analyzed a group of studies for these drugs’ effectiveness and tolerability for the elderly.
The scientists reviewed studies which met the following criteria:
- Included patients at or above 50 years of age
- Focused on patients diagnosed with insomnia, anxiety, or symptoms of dementia
- Compared benzodiazepines with a placebo, another medication, or psychotherapy
In their analysis, it was discovered that benzodiazepine prescription to older adults is significantly in excess of what would be appropriate. Indeed, this is echoed by other voices in the field. The American Geriatrics Society placed these drugs on a list of medications which should be avoided by patients over the age of 65. Several major psychiatric associations have also advised against the use of benzodiazepines by the elderly.
In spite of these recommendations and findings, benzodiazepines continue to be prescribed to the group most at risk of adverse side effects. In the US, more than 10% of women and 6% of men between the ages of 65 and 80 filled at least one prescription for benzos in a one-year period. Of these, a third reported receiving the drugs for longer than 120 days.
Today, researchers have identified yet another potential concern for older adults taking benzodiazepines: a higher risk of Alzheimer’s disease.
Benzodiazepines and Alzheimer’s
In a 2014 study, PhD student Sophie Billioti de Gage analyzed the prescription and medical services used by a random sample of older people (age >66) living in Quebec, Canada. Each participant had been diagnosed with Alzheimer’s during the study period. She and her colleagues evaluated benzodiazepine exposure in three categories:
- Ever use: at least one claim for benzodiazepines during the five to ten years prior to diagnosis,
- Cumulative dose: categories based on the amount of average exposure to the drug, and
- Drug elimination half-life: based on their medication, people were divided into users of short- (<20 hours) or long-acting benzodiazepines.
The result? Of the 8980 randomly selected individuals in Quebec with Alzheimer’s, the risk of this diagnosis was increased by 43% to 51% among those who had previously taken benzodiazepines. This risk increased with the density exposure or with the consumption of long-acting benzos. These findings are congruent with those of five previous studies, meaning that the prescription of these drugs should be evaluated by clinicians and family members alike. If you know someone who heavily uses benzodiazepines, we advise you to seek qualified addiction treatment as soon as possible.
Addiction Treatment for Older Adults
At Pine Grove, we understand the unique needs of older adults. That’s why we developed our Legacy program: an addiction treatment model designed specifically for those over 55 years of age. By participating in Legacy, adult patients can resolve an addiction to benzodiazepines or any number of other substances. For more information about treatment for older adults, contact the Pine Grove admissions team.
