Kuopio, Finland—Benzodiazepines are frequently prescribed to patients with dementia to manage neuropsychiatric conditions, but a new Finnish study cautions that the practice needs to be scrutinized.

The study, published in CMAJ (the Canadian Medical Association Journal), links use of the sedatives to a substantially increased risk of pneumonia in Alzheimer’s disease patients.
“An increased risk of pneumonia is an important finding to consider in treatment of patients with Alzheimer disease,” explains Heidi Taipale, PhD, of the Kuopio Research Centre of Geriatric Care at the University of Eastern Finland in Kuopio, Finland. “Benzodiazepines and Z-drugs are frequently prescribed for this population, and long-term use is typical. Pneumonia often leads to admission to hospital, and patients with dementia are at increased risk of death related to pneumonia.”

Background information in the article points out that dementia is a risk factor for pneumonia. Unfortunately, the study authors note, many patients with the condition are prescribed benzodiazepines and non-benzodiazepines, commonly called Z-drugs, both of which have sedative effects that can increase the risk of aspiration of saliva and food.

To reach their conclusions about risk, the researchers employed data from national registries on 49,484 community-dwelling adults—62.7% of them female with an average age of 80 years—diagnosed with Alzheimer’s disease between 2005 and 2011 in Finland. Those subjects were matched to 5,232 patients taking benzodiazepines and 3,269 patients on Z-drugs, with the remainder taking neither drug.

Results indicate that use of benzodiazepines was linked to a 30% increased risk of pneumonia in patients with Alzheimer’s disease, with the highest risk at initiation of the therapy within the first 30 days.

No statistically significant link was determined between use of Z-drugs and pneumonia, but the researchers have declined to suggest that those drugs were safer than benzodiazepines because the study did not directly compare them.

Previous studies have found an increased risk of pneumonia in patients of all ages taking benzodiazepines, according to study authors, who conclude, “Benefits and risks of the use of benzodiazepines should be carefully considered for patients with Alzheimer disease and include risk of pneumonia.”
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