Anticholinergic and benzodiazepine medication use and risk of incident dementia: a UK cohort study

Grossi, Carlota M., Richardson, Kathryn ORCID: https://orcid.org/0000-0002-0741-8413, Fox, Chris ORCID: https://orcid.org/0000-0001-9480-5704, Maidment, Ian, Steel, Nicholas ORCID: https://orcid.org/0000-0003-1528-140X, Loke, Yoon K., Arthur, Antony, Myint, Phyo Kyaw, Campbell, Noll, Boustani, Malaz, Robinson, Louise, Brayne, Carol, Matthews, Fiona E. and Savva, George M. (2019) Anticholinergic and benzodiazepine medication use and risk of incident dementia: a UK cohort study. BMC Geriatrics, 19. ISSN 1471-2318

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Abstract

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 5 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≤25 (IRR=0.94 [0.51-1.73]). Conclusions: Neither benzodiazepines nor ACB12 medications were associated with dementia. Recurrent use of ACB3 anticholinergics was associated with dementia, Page 4 of 29 particularly in those with good baseline cognitive function. The long-term prescribing of anticholinergics should be avoided in older people.

Item Type:	Article
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Health Promotion Faculty of Medicine and Health Sciences > Research Groups > Mental Health Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Groups > Dementia & Complexity in Later Life Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Centres > Institute for Volunteering Research Faculty of Medicine and Health Sciences > Research Centres > Population Health
Depositing User:	LivePure Connector
Date Deposited:	04 Oct 2019 12:30
Last Modified:	29 Jan 2024 02:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/72482
DOI:	10.1186/s12877-019-1280-2

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