Anticholinergic and benzodiazepine medication use and risk of incident dementia: a UK cohort study
Anticholinergic and benzodiazepine medication use and risk of incident dementia: a UK cohort study
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DOI：
10.1186/s12877-019-1280-2
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发表时间：
2019-10-21
期刊：
影响因子：
4.1
通讯作者：
Savva, George M.
中科院分区：
文献类型：
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作者：
Grossi, Carlota M.;Richardson, Kathryn;Savva, George M.
研究表明，抗胆碱能药物或苯二氮卓类药物的使用可能增加痴呆的风险。我们使用英国队列研究的数据验证了这一假设。方法采用医学研究委员会认知功能与衰老研究的基线（Y0）、2年（Y2）和10年（Y10）数据。纳入2岁时无痴呆的参与者（n = 8216）。根据抗胆碱能认知负担量表，苯二氮卓类药物（包括非苯二氮卓类药物）、3分抗胆碱能药物（ACB3）和1分或2分抗胆碱能药物（ACB12）的使用分为曾经使用（在Y0或Y2时使用）、反复使用（Y0和Y2）、新使用（Y2，但不是Y0）或停用（Y0，但不是Y2）。结果是10岁时发生痴呆。发病率比（IRR）使用泊松回归进行估计，校正了潜在的混杂因素。按年龄、性别和Y2迷你精神状态检查（MMSE）评分进行预先计划亚组分析。结果Y2 ~ Y10痴呆发生率为9.3%（220例）。苯二氮卓类药物、ACB3和ACB12的服用者与非服用者发生痴呆的调整后irs （95%CI）分别为1.06（0.72,1.60）、1.28（0.82,2.00）和0.89（0.68,1.17）。对于经常使用的人，irr分别为1.30(0.79,2.14),1.68（1.00,2.82）和0.95（0.71,1.28）。在Y2 MMSE患者中，曾使用ACB3与痴呆相关（IRR = 2.28[1.32-3.92]），但与Y2 MMSE患者无关
Background Studies suggest that anticholinergic medication or benzodiazepine use could increase dementia risk. We tested this hypothesis using data from a UK cohort study. Methods We used data from the baseline (Y0), 2-year (Y2) and 10-year (Y10) waves of the Medical Research Council Cognitive Function and Ageing Study. Participants without dementia at Y2 were included (n = 8216). Use of benzodiazepines (including nonbenzodiazepine Z-drugs), anticholinergics with score 3 (ACB3) and anticholinergics with score 1 or 2 (ACB12) according to the Anticholinergic Cognitive Burden scale were coded as ever use (use at Y0 or Y2), recurrent use (Y0 and Y2), new use (Y2, but not Y0) or discontinued use (Y0, but not Y2). The outcome was incident dementia by Y10. Incidence rate ratios (IRR) were estimated using Poisson regression adjusted for potential confounders. Pre-planned subgroup analyses were conducted by age, sex and Y2 Mini-Mental State Examination (MMSE) score. Results Dementia incidence was 9.3% (N = 220 cases) between Y2 and Y10. The adjusted IRRs (95%CI) of developing dementia were 1.06 (0.72, 1.60), 1.28 (0.82, 2.00) and 0.89 (0.68, 1.17) for benzodiazepines, ACB3 and ACB12 ever-users compared with non-users. For recurrent users the respective IRRs were 1.30 (0.79, 2.14), 1.68 (1.00, 2.82) and 0.95 (0.71, 1.28). ACB3 ever-use was associated with dementia among those with Y2 MMSE> 25 (IRR = 2.28 [1.32-3.92]), but not if Y2 MMSE