Moderating risk of Alzheimer's disease through the use of anxiolytic agents

被引:17
作者
Burke, Shanna L. [1 ]
O'Driscoll, Janice [1 ]
Alcide, Amary [1 ]
Li, Tan [2 ]
机构
[1] Florida Int Univ, Sch Social Work, Robert Stempel Coll Publ Hlth & Social Work, Miami, FL 33199 USA
[2] Florida Int Univ, Robert Stempel Coll Publ Hlth & Social Work, Dept Biostat, Miami, FL 33199 USA
关键词
alzheimer's disease; anxiolytics; anxiety; apolipoprotein; 4; mild cognitive impairment; benzodiazepine; MILD COGNITIVE IMPAIRMENT; ANXIETY; APOE; PERSONALITY; PROGRESSION; DEPRESSION; SYMPTOMS; ATROPHY; STRESS; IMPACT;
D O I
10.1002/gps.4614
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
ObjectivesAnxiety diagnoses occur in 17.1% in people age 65years and older. Individuals with anxiety may be at a higher risk of the development of probable Alzheimer's disease (AD). Previous literature has suggested that anxiolytic medications may exacerbate the risk of AD development. This study explored anxiolytic medication as a potential moderator of AD risk in older adults. MethodsA secondary data analysis of the National Alzheimer's Coordinating Center Uniform Data Set was undertaken, analyzing observations from 12,083 participants with normal cognition at the first visit. Survival analysis was utilized to examine if anxiolytic medication use by those with anxiety and/or APOE 4 moderates the hazard of AD and/or MCI development. ResultsThe hazard of probable AD (HR=3.50, [2.77 - 4.44], p<.0001) or MCI (HR=2.13, [1.85-2.44], p<.0001) development was statistically significant for those with anxiety. This hazard was no longer statistically significant when specific anxiolytics were used. 4 carriers experienced a statistically significant hazard of AD (HR=1.92, [1.52-2.41], p<.001) and MCI (HR=1.17, [1.04-1.32], p<.05) development. This effect was moderated by the use of anxiolytics. DiscussionThe results of this study suggest that anxiolytics may moderate the effect of anxiety on MCI and AD development, specifically indicating a neutralized hazard for those with 4 carriers with anxiety. Copyright (c) 2016 John Wiley & Sons, Ltd.
引用
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页码:1312 / 1321
页数:10
相关论文
共 47 条
[1]  
Alzheimers Association, 2015, Alzheimers Dement, V11, P332
[2]   Depression, anxiety and cognition in community-dwelling adults aged 70 years and over [J].
Bunce, David ;
Batterham, Philip J. ;
Mackinnon, Andrew J. ;
Christensen, Helen .
JOURNAL OF PSYCHIATRIC RESEARCH, 2012, 46 (12) :1662-1666
[3]   Depression and risk of developing dementia [J].
Byers, Amy L. ;
Yaffe, Kristine .
NATURE REVIEWS NEUROLOGY, 2011, 7 (06) :323-331
[4]  
Cascade Elisa, 2008, Psychiatry (Edgmont), V5, P21
[5]   A distinctive interaction between chronic anxiety and problem solving in asymptomatic APOE e4 homozygotes [J].
Caselli, RJ ;
Reiman, EM ;
Hentz, JG ;
Osborne, D ;
Alexander, GE .
JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES, 2004, 16 (03) :320-329
[6]  
CHOUINARD G, 1983, BIOL PSYCHIAT, V18, P451
[7]  
COX DR, 1972, J R STAT SOC B, V34, P187
[8]   Personality Factors Moderate the Associations Between Apolipoprotein Genotype and Cognitive Function as Well as Late Onset Alzheimer Disease [J].
Dar-Nimrod, Ilan ;
Chapman, Benjamin P. ;
Franks, Peter ;
Robbins, John ;
Porsteinsson, Anton ;
Mapstone, Mark ;
Duberstein, Paul R. .
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY, 2012, 20 (12) :1026-1035
[9]   Use of Benzodiazepines in Alzheimer's Disease: A Systematic Review of Literature [J].
Defrancesco, Michaela ;
Marksteiner, Josef ;
Fleischhacker, W. Wolfgang ;
Blasko, Imrich .
INTERNATIONAL JOURNAL OF NEUROPSYCHOPHARMACOLOGY, 2015, 18 (10)
[10]   The impact of anxiety on conversion from mild cognitive impairment to Alzheimer's disease [J].
Devier, Deidre J. ;
Pelton, Gregory H. ;
Tabert, Matthias H. ;
Liu, Xinhua ;
Cuasay, Katrina ;
Eisenstadt, Rachel ;
Marder, Karen ;
Stern, Yaakov ;
Devanand, D. P. .
INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, 2009, 24 (12) :1335-1342