© 1997 by European Journal of Public Health
ORIGINAL ARTICLES |
Impaired cognitive function in elderly men exposed to benzodiazepines or other anxiolytics
J. RANSTAM1,2,, J. MERLO2, G. BLENNOW3, B.S. HANSON2, P-O. ºSTERGREN2 and A. MELANDER1
1 The NEP1 Foundation, Malmö and Stockholm Sweden
2 Department of Community Medicine, Malmö University Hospital Malmö, Sweden
3 Department of Psychiatry, Lund University Hospital Lund, Sweden
Dr J. Ranstam, The NEPI Foundation, Medical Research Centre, Malmö University Hospital, S-205 02 Malmö, Sweden, tel. 
46 40 333496, fax 46 40 337306
A representative sample of 68 year old men living in Malmö, Sweden, was investigated concerning use of anxiolytic-hypnotic drugs. The subjects were psychometrically tested using the synonyms, Koh's block design, paired associates, visual retention, and digit symbol tests. Subjects with continuous use of anxiolytics, the vast majority of which consisted of benzodiazepines, had an increased risk of impaired cognitive function (RR=3.2 and p=0.008). Multivariate adjustments for differences in education, alcohol habits, exposure to organic solvents and stroke between users and non-users of anxiolytics did not reduce the estimate of risk (RR adj =3.4; 95% confidence interval: 1.3–8.9). Adjusting for differences in the number of subjects with a history of depression reduced the risk estimate slightly (RR adj =2.7; 95% confidence interval: 1.0–7.7) but adjustments for differences in anti-hypertensive and anti-diabetic medication had no influence. Subjects with occasional use of anxiolytics and subjects with occasional or continuous use of hypnotics showed no risk increase. Neither selection bias nor information bias appeared to explain the findings. Accordingly, increased caution is warranted when prescribing benzodiazepines for regular anxiolytic use.
Keywords: anxiolytics, benzodiazepines, cognitive function
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