BY SARAH OWENS
People with Alzheimer's disease who take benzodiazepines to treat symptoms of anxiety and agitation may have an increased risk of dying early, according to a study published online on November 15 in the International Journal of Geriatric Psychiatry.
Calming Drugs, but Dangerous Effects
Benzodiazepines such as Valium (diazepam), Xanax (alprazolam), and Klonopin (clonazepam) can have sedative, calming, and anti-anxiety effects, which can help treat anxiety or agitation for people with Alzheimer's disease. In fact, about one-third of people with Alzheimer's are prescribed a benzodiazepine after their diagnosis.
However, these drugs also have drawbacks, including an increased risk of falls, stroke, pneumonia, and hip fractures, all of which can lead to an early death. For that reason, current guidelines recommend that benzodiazepines be used on a short-term or infrequent basis for people with Alzheimer's disease. Still, the association between benzodiazepine use and early death in people with the disease has not been closely examined.
Looking for Trends in a Large Population
Researchers at universities in Finland and Sweden analyzed data from a large study that included people diagnosed with Alzheimer's disease between 2005 and 2011. They used a nationwide prescription drug register to identify the participants' use of benzodiazepines, including when they began taking the drugs, for how long, and what type they took. They identified 10,380 people with Alzheimer's disease who used benzodiazepines and matched them one-to-two with 20,760 people with Alzheimer's who did not use benzodiazepines.
Next, the researchers used nationwide medical registers to identify how many participants died, and when. Because the risks of benzodiazepines have been found to be highest in the period immediately after patients begin using them, the researchers identified deaths that occurred within the first 180 days of use.
Benzodiazepine Use Linked to Early Death
Benzodiazepine use among people with Alzheimer's disease was associated with a significant risk of death beginning immediately after use and lasting until four months later. Overall, people with Alzheimer's disease who used benzodiazepines had a 41 percent higher risk of an early death compared to those who did not.
The researchers hypothesized that older people may be particularly sensitive to the effects of benzodiazepines because of changes in how their bodies process drugs. These changes may amplify the effects of benzodiazepines on the central nervous system, which can include drowsiness, dizziness, confusion, and decreased respiration—all of which may, in turn, increase the risk of death.
As a result, the study authors concluded, doctors should start with non-drug solutions to treat psychological symptoms of Alzheimer's disease before prescribing drugs.