Risk of Dementia in Patients with Insomnia and Long-term Use of Hypnotics: A Population-based Retrospective Cohort Study

被引:129
作者
Chen, Pin-Liang [2 ]
Lee, Wei-Ju [2 ,3 ,4 ]
Sun, Wei-Zen [5 ]
Oyang, Yen-Jen [2 ,7 ]
Fuh, Jong-Ling [1 ,6 ]
机构
[1] Natl Yang Ming Univ, Sch Med, Fac Med, Taipei 112, Taiwan
[2] Natl Taiwan Univ, Dept Comp Sci & Informat Engn, Taipei 10764, Taiwan
[3] Taichung Vet Gen Hosp, Dept Neurol, Taichung, Taiwan
[4] Natl Yang Ming Univ, Inst Clin Med, Taipei 112, Taiwan
[5] Natl Taiwan Univ Hosp, Dept Anesthesiol, Taipei, Taiwan
[6] Taipei Vet Gen Hosp, Neurol Inst, Dept Neurol, Taipei, Taiwan
[7] Natl Taiwan Univ, Grad Inst Biomed Elect & Bioinformat, Taipei 10764, Taiwan
关键词
COGNITIVE DECLINE; BENZODIAZEPINE USE; ALZHEIMERS-DISEASE; DEPRESSIVE SYMPTOMS; DAYTIME SLEEPINESS; IMPAIRMENT; OLDER; PERFORMANCE; RECEPTORS; ASSOCIATION;
D O I
10.1371/journal.pone.0049113
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background: Hypnotics have been reported to be associated with dementia. However, the relationship between insomnia, hypnotics and dementia is still controversial. We sought to examine the risk of dementia in patients with long-term insomnia and the contribution of hypnotics. Methods: Data was collected from Taiwan's Longitudinal Health Insurance Database. The study cohort comprised all patients aged 50 years or older with a first diagnosis of insomnia from 2002 to 2007. The comparison cohort consisted of randomly selected patients matched by age and gender. Each patient was individually tracked for 3 years from their insomnia index date to identify whether the patient had a first diagnosis of dementia. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: We identified 5693 subjects with long-term insomnia and 28,465 individuals without. After adjusting for hypertension, diabetes mellitus, hyperlipidemia, and stroke, those with long-term insomnia had significantly higher risks of dementia (HR, 2.34; 95% CI, 1.92-2.85). Patients with long-term insomnia and aged 50 to 65 years had a higher increased risk of dementia (HR, 5.22; 95% CI, 2.62-10.41) than those older than 65 years (HR, 2.33; 95% CI, 1.90-2.88). The use of hypnotics with a longer half-life and at a higher prescribed dose predicted a greater increased risk of dementia. Conclusions: Patients with long-term use of hypnotics have more than a 2-fold increased risk of dementia, especially those aged 50 to 65 years. In addition, the dosage and half-lives of the hypnotics used should be considered, because greater exposure to these medications leads to a higher risk of developing dementia.
引用
收藏
页数:6
相关论文
共 52 条
[1]  
[Anonymous], 2002, The Ashton Manual
[2]  
Ballard C, 1996, INT J GERIATR PSYCH, V11, P987, DOI 10.1002/(SICI)1099-1166(199611)11:11<987::AID-GPS422>3.0.CO
[3]  
2-V
[4]   Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis [J].
Barker, MJ ;
Greenwood, KM ;
Jackson, M ;
Crowe, SF .
ARCHIVES OF CLINICAL NEUROPSYCHOLOGY, 2004, 19 (03) :437-454
[5]   MEMORY PERFORMANCE IN INDIVIDUALS WITH PRIMARY DEGENERATIVE DEMENTIA - ITS SIMILARITY TO DIAZEPAM-INDUCED IMPAIRMENTS [J].
BLOCK, RI ;
DEVOE, M ;
STANLEY, B ;
STANLEY, M ;
POMARA, N .
EXPERIMENTAL AGING RESEARCH, 1985, 11 (3-4) :151-155
[6]   EFFECTS OF CHRONIC BENZODIAZEPINE ADMINISTRATION ON NEUROPSYCHOLOGICAL PERFORMANCE [J].
BORNSTEIN, RA ;
WATSON, GD ;
PAWLUK, LK .
CLINICAL NEUROPHARMACOLOGY, 1985, 8 (04) :357-361
[7]   DRUG-INDUCED COGNITIVE IMPAIRMENT - DEFINING THE PROBLEM AND FINDING SOLUTIONS [J].
BOWEN, JD ;
LARSON, EB .
DRUGS & AGING, 1993, 3 (04) :349-357
[8]   WITHDRAWAL REACTION AFTER LONG-TERM THERAPEUTIC USE OF BENZODIAZEPINES [J].
BUSTO, U ;
SELLERS, EM ;
NARANJO, CA ;
CAPPELL, H ;
SANCHEZCRAIG, M ;
SYKORA, K .
NEW ENGLAND JOURNAL OF MEDICINE, 1986, 315 (14) :854-859
[9]   Non-steroidal anti-inflammatory drugs and risk of lower gastrointestinal adverse events: a nationwide study in Taiwan [J].
Chang, Chia-Hsuin ;
Lin, Jou-Wei ;
Chen, Hsi-Chieh ;
Kuo, Chuei-Wen ;
Shau, Wen-Yi ;
Lai, Mei-Shu .
GUT, 2011, 60 (10) :1372-1378
[10]   Validation of the National Health Insurance Research Database with ischemic stroke cases in Taiwan [J].
Cheng, Ching-Lan ;
Kao, Yea-Huei Yang ;
Lin, Swu-Jane ;
Lee, Cheng-Han ;
Lai, Ming Liang .
PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, 2011, 20 (03) :236-242