Association Between the Use of Hypnotics and the Risk of Alzheimer’s Disease

Article type: Research Article

Authors: Jeong, Wonjeong^{a; b; 1} | Joo, Jae Hong^{a; b} | Kim, Hyunkyu^{b; d} | Kim, Yun Kyung^{a; b} | Park, Eun-Cheol^{b; c} | Jang, Sung-In^{b; c; *}

Affiliations: [a] Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea | [b] Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea | [c] Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea | [d] Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea

Correspondence: [*] Correspondence to: Sung-In Jang, MD, PhD, Department of Preventive Medicine & Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea. Tel.: +82 2 2228 1863; Fax: +82 2 392 8133; E-mail: jangsi@yuhs.ac.

Note: [1] Orcid: https://orcid.org/0000-0002-7334-0140

Abstract: Background:Hypnotics, including benzodiazepines, are extensively and inappropriately prescribed for older people to treat anxiety and sleep disorders, despite the adverse health outcomes associated with their use. Objective:This study aimed to examine the association of the use of long- and short-acting hypnotics with the risk of Alzheimer’s disease. Methods:Data from 234,634 participants, derived from the Korean National Health Insurance Service National Sample Cohort from 2002 to 2013, were examined. Individuals over the age of 50 years were included in the study. The dependent variable was the risk of Alzheimer’s disease. Hypnotics were categorized by the period of the prescription of benzodiazepines, i.e., either till the participants were diagnosed with Alzheimer’s disease or the end of the study period (December 31, 2013). Cox regression model was built to analyze the association between variables. Results:Individuals who used long-acting hypnotics were found to have a higher risk of Alzheimer’s disease than non-users. Moreover, among individuals with sleep disorders, those who used hypnotics had a higher risk of Alzheimer’s disease than those who did not. Conclusion:This study identified an association between the use of hypnotics and the risk of Alzheimer’s disease among South Korean middle-aged and older people.

Keywords: Alzheimer’s disease, benzodiazepines, dementia, hypnotics

DOI: 10.3233/JAD-201319

Journal: Journal of Alzheimer's Disease, vol. 81, no. 4, pp. 1381-1389, 2021