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Case–control study
Benzodiazepine exposure increases risk of Alzheimer's disease
  1. Paul B Rosenberg
  1. Correspondence to: Johns Hopkins University School of Medicine, 5300 Alpha Commons Drive #429, Baltimore, MD 21224 USA; prosenb9{at}jhmi.edu

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Commentary on: Billioti de Gage S, Moride Y, Ducruet T, et al. Benzodiazepine use and risk of Alzheimer's disease: case-control study. BMJ 2014;349:g5205.

Context

Benzodiazepines (BZ) are widely prescribed for older patients. They have Food and Drug Administration (FDA) indications for a number of conditions including generalised anxiety disorder, panic disorder and insomnia. However, there are many worries about safety in the elderly including withdrawal, tolerance, ataxia, drug–drug interactions and adverse effects on cognition. For these reasons most guidelines recommend against long-term use of BZ. The study presents evidence for another type of toxicity, namely increasing the risk of incident Alzheimer's disease (AD) in the elderly.

Methods

A case–control epidemiological observational study using a large pharmacy database for the province of Quebec was performed. Patients with a diagnosis of AD (1796) were randomly sampled with 7184 controls matched on sex, age group and duration of follow-up. A logistic regression to …

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