Benzodiazepines and related drugs frequently used before and after diagnosis of Alzheimer's disease

Benzodiazepines and related drugs are initiated frequently in persons with Alzheimer's disease already before the diagnosis, and their use becomes even more common after the diagnosis, shows a recent study from the University of Eastern Finland. Benzodiazepines and related drugs are used as a sleep medication and for anxiolytic purposes. These drugs were initiated more frequently in persons with Alzheimer's disease than in persons not diagnosed with AD. Compared to persons not diagnosed with AD, it was three times more likely for persons with Alzheimer's disease to initiate benzodiazepine use after the diagnosis, and benzodiazepines were most commonly initiated six months after the diagnosis.

The findings are based on data from the Finnish Medication Use and Alzheimer's Disease Study, Medalz. Medalz comprises nationwide, extensive register-based data from the Finnish health care registers, and it includes all persons diagnosed with Alzheimer's disease in Finland between 2005 and 2011. The study, published now in Journal of Alzheimer's Disease, analysed the initiation of benzodiazepines and related drugs in 51,981 persons diagnosed with AD. Their use of drugs was monitored for a period of five years, and the follow-up started already two years before the diagnosis. The findings were compared to persons not diagnosed with Alzheimer's disease who were matched based on age and gender.

According to the Finnish Current Care Guidelines, benzodiazepines can be used on a short-term basis to treat behavioural problems associated with Alzheimer's disease. However, data on the benefits of these drugs in the treatment of behavioural problems is insufficient, but it is known that these drugs increase the risk of falls and cause cognitive impairment.

One of the earlier studies on Medalz study found that in Finland, benzodiazepines are used for extensive periods in persons with Alzheimer's disease. This, together with the current finding of frequent initiations of these drugs, paints a picture of a possible delay in AD diagnoses and concerning practice of symptom-based treatment before and around diagnosis.