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Benzodiazepine Use and Risk of Developing Alzheimer's Disease: A Case-Control Study Based on Swiss Claims Data
Biétry FA, Pfeil AM, Reich O, Schwenkglenks M, Meier CR.. CNS drugs, 2017-03-01
Topic: Drug trials: efficacy and safety
Background A possible association between benzodiazepine use and Alzheimer's disease (AD) has been hypothesized in previous studies. Objectives Using claims data from the Helsana Group, a large Swiss health insurance provider, we examined the association between previous benzodiazepine use and the risk of AD. Methods We conducted a matched case-control study and identified 1438 incident AD cases between 2013 and 2014 based on recorded first-time use of drugs used to treat AD [i.e., acetylcholinesterase inhibitors (donepezil, rivastigmine, and galantamine) and the N-methyl-D-aspartate receptor antagonist memantine] and matched one control to each case on age, sex, index date, and residence (canton). Because the initiation of benzodiazepine use shortly before the AD diagnosis date may occur as a result of symptomatic treatment of prodromal symptoms of early major neurocognitive disorder, we introduced an induction period of 2 years before the AD diagnosis date. Additionally, we categorized medication use by duration of use prior to the index date using prescriptions. We applied conditional logistic regression analyses to calculate odds ratios with 95% confidence intervals and adjusted for use of antidepressants. Results The crude odds ratio (95% confidence interval) of developing AD for patients starting benzodiazepine treatment was 1.71 (1.17-2.99) in the year before diagnosis and 1.19 (0.82-1.72) in the third year before diagnosis. After accounting for benzodiazepine use initiated during the prodromal phase, benzodiazepine use was not associated with an increased risk of developing AD; long-term benzodiazepine use (≥30 prescriptions) yielded an adjusted odds ratio of 0.78 (0.53-1.14). Conclusions After taking into consideration a possible protopathic bias in the 2 years preceding the AD diagnosis date, benzodiazepine use was not associated with an increased risk of developing AD.
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APA 7th
Biétry, F. A., Pfeil, A. M., Reich, O., Schwenkglenks, M., & Meier, C. R. (2017). Benzodiazepine Use and Risk of Developing Alzheimer's Disease: A Case-Control Study Based on Swiss Claims Data. CNS drugs. https://doi.org/10.1007/s40263-016-0404-x
Vancouver
Biétry FA, Pfeil AM, Reich O, Schwenkglenks M, Meier CR. Benzodiazepine Use and Risk of Developing Alzheimer's Disease: A Case-Control Study Based on Swiss Claims Data. CNS drugs. 2017. doi:10.1007/s40263-016-0404-x. PMID: 28078633.
BibTeX
@article{bietry2017-28078633,
author = {Biétry, F. A. and Pfeil, A. M. and Reich, O. and Schwenkglenks, M. and Meier, C. R.},
title = {{Benzodiazepine Use and Risk of Developing Alzheimer's Disease: A Case-Control Study Based on Swiss Claims Data}},
journal = {CNS drugs},
year = {2017},
doi = {10.1007/s40263-016-0404-x},
pmid = {28078633},
url = {https://doi.org/10.1007/s40263-016-0404-x}
}
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Key findings
- Because the initiation of benzodiazepine use shortly before the AD diagnosis date may occur as a result of symptomatic treatment of prodromal symptoms of early major neurocognitive disorder, we introduced an induction period of 2 years before the AD diagnosis date.
- Results The crude odds ratio (95% confidence interval) of developing AD for patients starting benzodiazepine treatment was 1.71 (1.17-2.99) in the year before diagnosis and 1.19 (0.82-1.72) in the third year before diagnosis.
- After accounting for benzodiazepine use initiated during the prodromal phase, benzodiazepine use was not associated with an increased risk of developing AD; long-term benzodiazepine use (≥30 prescriptions) yielded an adjusted odds ratio of 0.78 (0.53-1.14).
- Conclusions After taking into consideration a possible protopathic bias in the 2 years preceding the AD diagnosis date, benzodiazepine use was not associated with an increased risk of developing AD.
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Study details
- Study designcase-control study
- Evidence strengthModerate
How this study scored 52/100
Published in a peer-reviewed journal, and it is a case-control study. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 30 of the 58 points we could judge it on, which is 52 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (CNS drugs) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 6 / 12 | A case-control study |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2017 — within 10 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 28078633) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 30 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 30 of the 58 points we could judge it on is 52 out of 100. |
| Total | 52 / 100 | — |
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