Intended for healthcare professionals


Benzodiazepines and risk of Alzheimer’s disease

BMJ 2014; 349 doi: (Published 09 September 2014) Cite this as: BMJ 2014;349:g5312
  1. Kristine Yaffe, Roy and Marie Scola endowed chair and professor of psychiatry12,
  2. Malaz Boustani, Richard M Fairbanks professor in aging research34
  1. 1University of California at San Francisco, San Francisco, CA, USA
  2. 2San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
  3. 3Indiana University Center for Aging Research, Indianapolis, IN, USA
  4. 4Regenstrief Institute, Indianapolis, IN, USA
  1. Correspondence to: K Yaffe, 4150 Clement St, Box 181G, San Francisco, CA 94121, USA kristine.yaffe{at}

Prescribers and patients need a proper surveillance system for cognitive side effects

A growing number of observational studies have shown the critical role of potentially inappropriate medications for increasing the risk of cognitive impairment. In a linked paper, Billioti de Gage and colleagues (doi:10.1136/bmj.g5205) extend the pharmacoepidemiological research on the adverse cognitive effects of benzodiazepines with an investigation of their link with Alzheimer’s disease.1 Their results suggest that long term exposure to benzodiazepines might be a modifiable risk factor for this condition.

The authors conducted a nested case-control study of about 2000 older members of a public drug plan in the province of Quebec, Canada. They observed a cumulative dose-effect association between exposure to benzodiazepines (at least 90 days) and risk of developing Alzheimer’s disease and found that exposure lasting more than 180 days was associated with a nearly twofold increase in risk. In further analyses, they showed that longer acting benzodiazepines were associated with greater risk of developing Alzheimer’s disease compared with shorter acting benzodiazepines, adding support for a causal association.

The interpretation of these findings is …

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