Neuropathological Correlates of Cumulative Benzodiazepine and Anticholinergic Drug Use
| Autor: | Chris Fox, Antony Arthur, Yoon K. Loke, George M. Savva, Nicholas Steel, Ian Maidment, Malaz Boustani, Noll L. Campbell, Stephen B. Wharton, Kathryn Richardson, Louise Robinson, Carlota M. Grossi, Carol Brayne, Phyo K. Myint, Fiona E. Matthews |
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| Přispěvatelé: | Brayne, Carol [0000-0001-5307-663X], Apollo - University of Cambridge Repository |
| Rok vydání: | 2020 |
| Předmět: |
Male
0301 basic medicine Drug Aging medicine.medical_specialty medicine.drug_class media_common.quotation_subject Population Neuropathology Cholinergic Antagonists Benzodiazepines 03 medical and health sciences Cognition 0302 clinical medicine Cost of Illness Alzheimer Disease Internal medicine Anticholinergic medicine Humans Dementia Cognitive decline education Aged media_common Aged 80 and over Cerebral Cortex neuropathology Benzodiazepine education.field_of_study basal nucleus of Meynert business.industry General Neuroscience Neurofibrillary Tangles General Medicine Odds ratio neuritic plaques medicine.disease Substantia Nigra Psychiatry and Mental health Clinical Psychology 030104 developmental biology Female Atrophy Geriatrics and Gerontology business Alzheimer’s disease 030217 neurology & neurosurgery |
| Zdroj: | Journal of Alzheimer's Disease. 74:999-1009 |
| ISSN: | 1875-8908 1387-2877 |
| DOI: | 10.3233/jad-191199 |
| Popis: | Background:\ud Benzodiazepines and anticholinergic drugs have been implicated in causing cognitive decline and potentially increasing dementia risk. However, evidence for an association with neuropathology is limited.\ud \ud Objective:\ud To estimate the correlation between neuropathology at death and prior use of benzodiazepines and anticholinergic drugs.\ud \ud Methods:\ud We categorized 298 brain donors from the population-based Medical Research Council Cognitive Function and Ageing Study, according to their history of benzodiazepine (including Z-drugs) or anticholinergic medication (drugs scoring 3 on the Anticholinergic Cognitive Burden scale) use. We used logistic regression to compare dichotomized neuropathological features for those with and without history of benzodiazepine and anticholinergic drug use before dementia, adjusted for confounders.\ud \ud Results:\ud Forty-nine (16%) and 51 (17%) participants reported benzodiazepine and anticholinergic drug use. Alzheimer’s disease neuropathologic change was similar whether or not exposed to either drug, for example 46% and 57% had intermediate/high levels among those with and without anticholinergic drug use. Although not significant after multiple testing adjustments, we estimated an odds ratio (OR) of 0.40 (95% confidence interval [95% CI] 0.18–0.87) for anticholinergic use and cortical atrophy. For benzodiazepine use, we estimated ORs of 4.63 (1.11–19.24) and 3.30 (1.02–10.68) for neuronal loss in the nucleus basalis and substantial nigra. There was evidence of neuronal loss in the nucleus basalis with anticholinergic drug use, but the association reduced when adjusted for confounders.\ud \ud Conclusions:\ud We found no evidence that benzodiazepine or anticholinergic drug use is associated with typical pathological features of Alzheimer’s disease; however, we cannot rule out effects owing to small numbers. |
| Databáze: | OpenAIRE |
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