Benzodiazepines increase risk of pneumonia in people with dementia: study

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People who have dementia and take benzodiazepines are at a 30% increased risk of developing pneumonia compared with those with dementia taking Z-drugs and those taking neither type of medication, according to a study published Monday by the Canadian Medical Association Journal.

The risk was highest during the first 30 days of treatment, the researchers found.

“Benzodiazepines and Z-drugs are frequently prescribed for this population, and long-term use is typical,” wrote Heidi Taipale, Ph.D., Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland, with coauthors. “Pneumonia often leads to admission to hospital, and patients with dementia are at increased risk of death related to pneumonia.”

The sedative nature of benzodiazepines may increase the risk of pneumonia by increasing the aspiration of saliva or food into the lungs, the authors said. Their findings are consistent with studies that have found an increased risk of pneumonia in people of all ages who take benzodiazepines.

“Benefits and risks of the use of benzodiazepines should be carefully considered for patients with Alzheimer's disease and include risk of pneumonia,” the authors concluded.

“Nonpharmacologic approaches should be the starting point when managing neuropsychiatric symptoms in this patient population, which should help to limit inappropriate use of these drugs,” Paula Rochon, M.D., MPH, from Women's College Hospital and the University of Toronto, and coauthors wrote in a related commentary.

The drugs also appear to be inappropriately prescribed in the United States, according to research published in 2015 in JAMA Psychiatry. At the time, one of the authors of the U.S. research told McKnight's Senior Living that overuse of benzodiazepines in older adults can lead to falls and other accidents as well as difficulty in quitting the drugs.

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