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Sedative use and incident cognitive decline among persons aged 75 years and older: a population-based longitudinal study

  • Franciska Desplenter (a1) (a2) (a3), Piia Lavikainen (a1) (a2), Sirpa Hartikainen (a1) (a2) (a4), Raimo Sulkava (a5) (a6) and J. Simon Bell (a1) (a2) (a7)...


Background: Acute exposure to sedative drugs may induce memory impairment, but there is mixed evidence that long-term sedative use may result in incident cognitive decline. The objective of this study was to investigate the use of sedative drugs and incident cognitive decline in a population-based sample of persons aged 75 years and older.

Methods: The study sample comprised 781 participants in the Geriatric Multidisciplinary Strategy for the Good Care of the Elderly (GeMS) study in Kuopio, Finland. Data on health status, drug use, and sociodemographic factors were elicited during annual nurse interviews from 2004 to 2007. A linear mixed model was used to compare change in Mini-Mental State Examination (MMSE) scores (2005–2007) among users of sedative drugs in 2004 and 2005 (n = 139) to non-users of sedative drugs from 2004 to 2007 (n = 310). The model was adjusted for covariates including age, gender, education, depressive symptoms and antipsychotic use.

Results: Unadjusted mean MMSE scores were 27.50 in 2005, 26.58 in 2006, and 25.95 in 2007 among users of sedative drugs. Unadjusted mean MMSE scores were 28.05 in 2005, 27.61 in 2006, and 27.09 in 2007 among non-users of sedative drugs. Adjusted mean MMSE scores were 0.31 points lower in 2005, 0.62 points lower in 2006, and 0.93 lower in 2007 among users compared to non-users of sedative drugs (P = 0.051).

Conclusions: Sedatives were not associated with statistically significant cognitive decline. However, clinicians should maintain a judicious approach to prescribing sedative drugs given the risk of adverse drug events.


Corresponding author

Correspondence should be addressed to: J. Simon Bell, PhD, Associate Professor, Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Frome Road, Adelaide, 5000, Australia. Phone: +61 8 8302 2419. Email:


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Allard, J., Artero, S. and Ritchie, K. (2003). Consumption of psychotropic medication in the elderly: a re-evaluation of its effect on cognitive performance. International Journal of Geriatric Psychiatry, 18, 874878.
Assem-Hilger, E., Jungwirth, S., Weissgram, S., Kirchmeyr, W., Fischer, P. and Barnas, C. (2009). Benzodiazepine use in the elderly: an indicator for inappropriately treated geriatric depression? International Journal of Geriatric Psychiatry, 24, 563569.
Azad, N. A., Al Bugami, M. and Loy-English, I. (2007). Gender differences in dementia risk factors. Gender Medicine, 4, 120129.
Barker, M. J., Greenwood, K. M., Jackson, M. and Crowe, S. F. (2004). Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis. Archives of Clinical Neuropsychology, 19, 437454.
Belleville, G. (2010). Mortality hazard associated with anxiolytic and hypnotic drug use in the national population health survey. Canadian Journal of Psychiatry, 55, 558567.
Byerly, M. J., Weber, M. T., Brooks, D. L., Snow, L. R., Worley, M. A. and Lescouflair, E. (2001). Antipsychotic medications and the elderly: effects on cognition and implications for use. Drugs and Aging, 18, 4561.
Dealberto, M. J., McAvay, G. J., Seeman, T. and Berkman, L. (1997). Psychotropic drug use and cognitive decline among older men and women. International Journal of Geriatric Psychiatry, 12, 567574.
Dewey, M. E. and Saz, P. (2001). Dementia, cognitive impairment and mortality in persons aged 65 and over living in the community: a systematic review of the literature. International Journal of Geriatric Psychiatry, 16, 751761.
Fastbom, J., Forsell, Y. and Winblad, B. (1998). Benzodiazepines may have protective effects against Alzheimer disease. Alzheimer Disease and Associated Disorders, 12, 1417.
Fortin, D. et al. (2007). Factors associated with long-term benzodiazepine use among elderly women and men in Quebec. Journal of Women and Aging, 19, 3752.
Hanlon, J. T. et al. (1998). Benzodiazepine use and cognitive function among community-dwelling elderly. Clinical Pharmacology and Therapeutics, 64, 684692.
Kidd, P. M. (2008). Alzheimer's disease, amnestic mild cognitive impairment, and age-associated memory impairment: current understanding and progress toward integrative prevention. Alternative Medicine Review, 13, 85115.
Lagnaoui, R. et al. (2002). Benzodiazepine use and risk of dementia: a nested case-control study. Journal of Clinical Epidemiology, 55, 314318.
Lagnaoui, R. et al. (2004). Patterns and correlates of benzodiazepine use in the French general population. European Journal of Clinical Pharmacology, 60, 523529.
Lagnaoui, R. et al. (2009). The risk of cognitive impairment in older community-dwelling women after benzodiazepine use. Age and Ageing, 39, 226228.
Madhusoodanan, S. and Bogunovic, O. J. (2004). Safety of benzodiazepines in the geriatric population. Expert Opinion on Drug Safety, 3, 485493.
McLachlan, A. J., Hilmer, S. N. and Le Couteur, D. (2009). Variability in response to medicines in older people: phenotypic and genotypic factors. Clinical Pharmacology and Therapeutics, 85, 431433.
McShane, R., Keene, J., Gedling, K., Fairburn, C., Jacoby, R. and Hope, T. (1997). Do neuroleptic drugs hasten cognitive decline in dementia? Prospective study with necropsy follow up. BMJ, 314, 266270.
Moride, Y. and Abenhaim, L. (1994). Evidence of the depletion of susceptibles effect in non-experimental pharmacoepidemiologic research. Journal of Clinical Epidemiology, 47, 731737.
Mossello, E. et al. (2008). Is antidepressant treatment associated with reduced cognitive decline in Alzheimer's disease? Dementia and Geriatric Cognitive Disorders, 25, 372379.
Paterniti, S., Dufouil, C. and Alperovitch, A. (2002). Long-term benzodiazepine use and cognitive decline in the elderly: the Epidemiology of Vascular Aging Study. Journal of Clinical Psychopharmacology, 22, 285293.
Paterniti, S., Verdier-Taillefer, M. H., Dufouil, C. and Alpérovitch, A. (2002). Depressive symptoms and cognitive decline in elderly people: a longitudinal study. British Journal of Psychiatry, 181, 406410.
Rikala, M., Korhonen, M. J., Sulkava, R. and Hartikainen, S. (2011). The effects of medication assessment on psychotropic drug use in the community-dwelling elderly. International Psychogeriatrics, 23, 473484.
Stern, Y. (2006). Cognitive reserve and Alzheimer disease. Alzheimer Disease and Associated Disorders, 20 (Suppl. 2), S69S74.
Stewart, S. A. (2005). The effects of benzodiazepines on cognition. Journal of Clinical Psychiatry, 66 (Suppl. 2), 913.
Tangalos, E. G. et al. (1996). The Mini-Mental State Examination in general medical practice: clinical utility and acceptance. Mayo Clinic Proceedings, 71, 829837.
van Vliet, P., van der Mast, R. C., van den Broek, M., Westendorp, R. G. and de Craen, A. J. (2009). Use of benzodiazepines, depressive symptoms and cognitive function in old age. International Journal of Geriatric Psychiatry, 24, 500508.
Verbeke, G. and Molenberghs, G. (2000). Linear Mixed Models for Longitudinal Data. New York: Springer.
Wright, R. M. et al. (2009). Effect of central nervous system medication use on decline in cognition in community-dwelling older adults: findings from the Health, Aging And Body Composition Study. Journal of the American Geriatrics Society, 57, 243250.


Sedative use and incident cognitive decline among persons aged 75 years and older: a population-based longitudinal study

  • Franciska Desplenter (a1) (a2) (a3), Piia Lavikainen (a1) (a2), Sirpa Hartikainen (a1) (a2) (a4), Raimo Sulkava (a5) (a6) and J. Simon Bell (a1) (a2) (a7)...


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