Benzodiazepine And Related Drug Use And Risk Of Dementia:A System Meta-analysis

Background: Benzodiazepines and benzodiazepine‐related drugs(BZDRs)are very common in the elder population to treat diverse psychiatric disorders,including anxiety,insomnia,and depressive symptoms.BZDRs are known to affect memory and cognitive function.However,whether there is increased risk of dementia in individuals who regularly and orally administrated BZDRs are not clear.Objective and Methods: We searched observational studies which explored the association between BZDR use and the risk of dementia in the Pub Med,EMBASE,Cochrane,and Web of Science electronic databases from September to December 2019.We limited our searches to human subjects and limited language to English.The pooled odds ratio(OR)and 95% confidence interval(CI)were evaluated using the random effect models.Subgroup analysis and sensitivity analysis were performed to assess the source of heterogeneity,and the publication bias were assessed by Egger’s test.Results: In total,12 case-control studies with 1,233,831 participants and 7 cohort studies with 441,491 participants were included in our meta-analysis.BZDR use was associated with an increased risk of dementia in case-control studies with high heterogeneity(OR = 1.31;95%CI,1.14-1.50;I2 = 99%;p < 0.01)and cohort studies with high heterogeneity(OR = 1.23;95%CI,1.04-1.47;I2 = 74%;p < 0.01).Based on exposure cumulative period per year,we found an increased risk of dementia in longer duration(> 180 days)(OR = 1.57;95%CI,1.32-1.88;I2 = 76%;p = 0.02)and 90-180 cumulative days(OR = 1.43;95%CI,1.27-1.62;I2 = 0%;p = 0.72).And long-acting BZDR use was associated with an increased risk of dementia(OR = 1.13;95%CI,1.00-1.29;I~2 = 92%;p < 0.01).Conclusion: The oral administration of BZDR may increase the risk of dementia.Clinicians need to concern the trade-off between the advantages and the possible risk of dementia for BZDR use.