New MRI study contradicts prior research linking dementia with benzodiazepine use

A recent study is offering new insight into how the use of benzodiazepines affects users’ brain health. 

There has long been speculation that chronic benzo use could be a precursor to conditions like dementia that are known to deteriorate neurological function. That was not the conclusion of this latest research. However, experts did find links between benzo use and lower brain across multiple areas of the organ. 

The findings were published July 2 in BMC Medical

“Benzodiazepines are the most commonly prescribed psychotropic medication in developed countries, and the number of prescriptions is increasing,” corresponding author Frank J. Wolters, with the department of epidemiology at Erasmus University Medical Center in the Netherlands, and colleagues noted. “Guidelines discourage long-term use due to risk of psychological and physical dependence, falls, and cognitive impairment, especially in older adults. Nevertheless, approximately 30%–40% of older benzodiazepine users continue use beyond the recommended period of several weeks.” 

Experts used MR imaging to monitor changes in the brains of people who had used benzos before—for both short- and long-term periods of time—and compared them to a group of individuals who had never taken the anxiety medication. The cohort included more than 5,400 people, all of whom had at least one baseline MRI scan; over 4,800 had both baseline and repeat imaging available, allowing researchers to analyze any changes that occurred over time. 

Using participants’ medical records, experts did not note any significant differences in the likelihood of developing dementia later in life between the group who used benzos of any kind (anxiolytics or sedative-hypnotics) for any period of time and the group that had never used them. More diagnoses of dementia among individuals who had higher cumulative doses of anxiolytics were observed, but the group did not determine causality. 

In the benzo cohort, lower brain volumes were observed in the hippocampus, amygdala and thalamus, with accelerated volume loss of the hippocampus. These changes were found to correlate with individuals’ current use of the medication, rather than their cumulative doses. 

“Our results indicate that benzodiazepine use may have subtle, long-term impact on brain health, although we found no evidence of a dose–response relationship, and in contrast to dementia analyses, subgroup analyses did not support stronger effects in anxiolytics use compared to use of sedative-hypnotics,” the group explained, adding that their findings further support guidelines cautioning against long-term use of benzodiazepines. 

The study abstract is available here

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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.

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