Medications for anxiety may be associated with Alzheimer's disease

Long-term use of drugs in the elderly is a concern, say researchers

A new study shows that older adults who are used to using sedatives for anxiety and insomnia may have an increased risk of developing Alzheimer's disease. We are talking about benzodiazepines - this is a group of sedatives that are often prescribed, this group includes lorazepam (Aktivan), diazepam (Valium) and alprazolam (Xanax). According to background information from the study, anti-anxiety and insomnia medications are often taken by older adults over a longer period of time.

This is despite recommendations warning that these drugs should only be taken for short periods of time. In 2012, the American Geriatrics Society (AGS) listed benzodiazepines as "potentially inappropriate" for the elderly, due to the risk of disorders such as confusion, dizziness and falls.

The mentioned study is not the first to link benzodiazepines with the risk of Alzheimer's disease, but according to the lead researcher, PhD candidate Sophie Billioti de Gage from the University of Bordeaux in France, it is another piece of evidence that the use of the drugs over a longer period of time - more than three months - could be a risk factor.

"For patients who need or use benzodiazepines, it seems crucial to encourage doctors to more carefully weigh the benefits and risks when renewing prescriptions," said Billioti de Gage. But the study was only able to find an association between the drugs and the risk of Alzheimer's disease. According to geriatrics expert Dr. Gisele Wolf-Klein, who was not involved in the project, the study was not designed to definitively prove that the drugs caused memory loss. One reason is that the findings are based on prescription records. "We know the drugs were prescribed, but we don't know how often people were taking them or if they were taking them at all," said Dr. Wolf-Klein, director of geriatric education at North Shore-LIJ Health Center in New Hyde Park, N.Y. York. Regardless of everything, benzodiazepines already have a lot of known risks that call for concern, the doctor pointed out.

"There is absolutely no question that these drugs have dangerous side effects," Wolf-Klein said. "It is important that people understand the danger of possible addiction and the increased risk of confusion and falls.

The study was published online on September 9, 2014 in the journal The British Medical Journal (BMJ). For this project, the scientific team gathered around the future doctor Billioti de Gage, examined the history of almost 1,800 older adults with Alzheimer's disease, comparing each of them with four people of the same age and sex without dementia.

They found that people who were prescribed benzodiazepines for more than three months were 51 percent more likely to develop Alzheimer's disease than people who never used the drugs. The risk almost doubled if they took the medication for more than six months.

According to Billiota de Gage, people in the early stages of Alzheimer's disease may have symptoms such as sleep problems and anxiety. This raises the possibility that benzodiazepine use is a result of Alzheimer's disease rather than a cause of the disease. She said her research was designed to prove otherwise. They considered only prescriptions that were started at least five years before the diagnosis of Alzheimer's disease.

Billioti de Gage claims that these drugs can only be useful in the short term. She pointed out that research in the study did not show an increased risk of Alzheimer's disease in older adults who were prescribed drugs in accordance with international guidelines; this means that they use them for no longer than one month for insomnia and no more than three months for anxiety symptoms.

dr. Malaz Boustani, who contributed to the editorial published in the study, says that older adults need to be careful when using these drugs, or any other drug that can affect brain function. "We should consider the side effects of these drugs much more seriously," said Boustani, a researcher at the Regenstrief Institute and Indiana University Center for the Study of Aging in Indianapolis.

According to the AGS, a number of medications can cause older adults to feel groggy and confused. They include other types of sleeping pills, such as zaleplon (Sonata) and zolpidem (Ambien); antihistamines such as diphenhydramine (Benadryl) and chlorpheniramine (AllerChlor, Chlor-Trimeton); this includes muscle relaxants.

Both Boustani and Wolf-Klein suggested exploring non-drug therapies for sleep problems and anxiety, in part because drugs don't address the underlying problems.

When an older person seems to be having trouble sleeping, changes in habits -- such as avoiding caffeine or limiting fluid intake during the night -- may be enough, Wolf-Klein said. When the problem is an anxiety disorder, Boustani believes that cognitive-behavioral therapy (talk therapy) is often effective.

"The point is that we have to take care of our brain," Boustani said, adding: "The first step is not to do any damage."

Original:

https://www.webmd.com/alzheimers/news/20140909/anxiety-medications-may-be-tied-to-alzheimers-risk#2

By Amy Norton September 9, 2014