SynthesisCNS drugs2018
A Systematic Review and Meta-Analysis of the Risk of Dementia Associated with Benzodiazepine Use, After Controlling for Protopathic Bias.
Synthesis in CNS drugs, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 4 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- Pooled it
- Is there a link between the use of benzodiazepines and related drugs and dementia? A systematic review of reviews.European geriatric medicine · 2022Pooled it
- Occupational Injuries and Use of Benzodiazepines: A Systematic Review and Metanalysis.Frontiers in human neuroscience · 2021Pooled it
- The Effects of Benzodiazepine Use and Abuse on Cognition in the Elders: A Systematic Review and Meta-Analysis of Comparative Studies.Frontiers in psychiatry · 2020Pooled it
- Navigating complex interactions between psychiatric disorders and their treatment in pregnancy: Clinical implications.Journal of the Chinese Medical Association : JCMA · 2026Article
- Enhanced interhemispheric functional connectivity in elderly anxiety patients with long-term benzodiazepine use: an fNIRS study.Scientific reports · 2026Article
- Benzodiazepine Dependence: Clinical and Molecular Aspects, Preventive Strategies and Therapeutic Approaches.International journal of molecular sciences · 2026Review
- Benzodiazepine prescribing patterns among Medicare providers, 2017 to 2023.Frontiers in medicine · 2026Article
- Analysis of postmarketing neuropsychiatric adverse events of avapritinib based on the FDA adverse event reporting system.Scientific reports · 2025Article
- Medication Exposure and Risk of Dementia and Alzheimer's Disease.International journal of molecular sciences · 2024Review
- Article
- Association Between Hypnotics and Dementia: A Mini Narrative Review.Psychiatry investigation · 2024Article
- Benzodiazepine use and risk of incident MCI and dementia in a community sample.International psychogeriatrics · 2024Article
- Benzodiazepine Use and the Risk of Dementia in the Elderly Population: An Umbrella Review of Meta-Analyses.Journal of personalized medicine · 2023Review
- Trajectories of Benzodiazepine Use among Older Adults from a Concordance-with-Guidelines Perspective: A Nationwide Cohort Study.Drugs & aging · 2023Article
- Associations of Late-Life Sleep Medication Use With Incident Dementia in the Atherosclerosis Risk in Communities Study.The journals of gerontology. Series A, Biological sciences and medical sciences · 2023Article
- Optimizing treatment for older adults with depression.Therapeutic advances in psychopharmacology · 2023Review
- Long-term use of benzodiazepines in chronic insomnia: a European perspective.Frontiers in psychiatry · 2023Article
- Melatonin as a Harmonizing Factor of Circadian Rhythms, Neuronal Cell Cycle and Neurogenesis: Additional Arguments for Its Therapeutic Use in Alzheimer's Disease.Current neuropharmacology · 2023Review
- Translocator protein (18kDa) TSPO: a new diagnostic or therapeutic target for stress-related disorders?Molecular psychiatry · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBenzodiazepine use is highly prevalent in elderly and late middle-aged populations and may be associated with an increased risk of dementia. Observational studies have suggested that benzodiazepine use may increase the risk of dementia, however there have been significant concerns regarding protopathic bias in these studies, precluding conclusive findings.
objectiveThe aim of our study was to investigate the risk of dementia associated with the use of benzodiazepines in elderly patients, after controlling for protopathic bias.
methodsWe identified observational studies with more than 50 cases, adequate assessment of benzodiazepine exposure, and reliable dementia diagnosis ascertainment, from the MEDLINE, PubMed, EMBASE, CINAHL, LILACS and CENTRAL electronic databases through to 5 June 2018, with no language limits. The association of any current or former use of short- or long-acting benzodiazepines with incident dementia was analysed. A subgroup analysis was performed by the introduction of lag time to assess the effect of protopathic bias. We also performed analyses considering the effect of higher benzodiazepine cumulative doses and adjustment for psychiatric covariates. Study quality was investigated using the Newcastle-Ottawa Scale.
resultsWe identified 15 studies reported in 14 articles, involving 159,090 cases. Ever use of benzodiazepines was associated with a significantly increased risk of dementia [odds ratio (OR) 1.39, 95% confidence interval (CI) 1.21-1.59]. Those studies that implemented the longest lag times of ≥ 5 years, and hence most likely to overcome protopathic bias, found a risk estimate that was marginally attenuated, but still significant (OR 1.30, 95% CI 1.14-1.48). Long-acting benzodiazepines were associated with a marginally higher magnitude risk (OR 1.21, 95% CI 0.99-1.49) than short-acting benzodiazepines (OR 1.13, 95% CI 1.02-1.26), although the former failed to reach statistical significance (p = 0.059).
conclusionsOur findings indicate that the association between benzodiazepine use and dementia incidence is not purely an artefact due to protopathic bias. Reduction of inappropriate benzodiazepine prescription is likely to attenuate dementia risk.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.