Home > Dementia risk, Medical issues, Medication, Psychological issues > Tranquilizers and Dementia Risk

Tranquilizers and Dementia Risk

A new study, reported in the British Medical Journal, has suggested that older adults who begin taking tranquilizers such as Ativan and Valium have a significantly greater chance of developing dementia than those who don’t use such medications.

The study looked at about 1,000 older adults in France, over a 15 year period of time.  Study participants had an average age of 79, when enrolled.  None of them had dementia, or used a class of tranquilizers called benzodiazepines.  This class includes drugs such as Valium, Ativan, Xanax, Librium, Klonopin, and Restoril, (as well as others) and are frequently used by the French to treat anxiety and to help with sleep.  All of these medications are known to produce the side effects of confusion and memory loss.  It had previously been suggested that they were linked to dementia, but this study sought to verify and quantify this relationship.

During the course of the study, approximately ten percent of participants were prescribed one of the benzodiazepines by their physicians, for a variety of conditions.  At the end of the 15-year study, these persons were found to have a 50 percent greater incidence of dementia than study participants who did not take the drugs.  Researchers were careful to avoid “selection bias,” or the inclusion of persons who needed tranquilizers because they were already in the early stages of dementia.  They were careful to control for such factors as age, gender, marital status, education, alcohol consumption, diabetes, high blood pressure, depression, and early signs of dementia.

There has already been a push in this country to reduce the use of benzodiazepines in the elderly.  Their use has been associated with memory loss, as well as balance problems and fractures due to falls.  Medicare has labelled them as “high risk medications.”  The study described here only adds ammunition to the argument that these drugs should be used cautiously with this population.  (However, it should be noted that there are times when the necessity for the use of any drug supersedes the possibility of any potential side effects.)

Speaking strictly from personal opinion (and that of several of my co-workers), I have been saddened in the past to see how frequently some of these drugs are used with the geriatric population.  (Especially with long-term care residents, who are the people I have had the most exposure to.)  So often, one of the first actions taken when a person displays behavioral problems, particularly a catastrophic reaction of some sort, is to give a pill.  This is changing, to be sure, but continues to happen far too often.  What we need to be doing is trying non-pharmacological remedies, including making modifications to the environment so that these sort of reactions don’t happen in the first place.  More and more strategies are being found to be very effective in dealing with behavioral problems, and I have tried to talk about some of them on this site.

Don’t get me wrong.  There are times when medications are absolutely necessary, and should be used.  But I do think we need to take another look at how often we use this as a first course of action, when there are other things we could be doing that would work just as well and have fewer lasting side effects.

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