Benzodiazepine utilization patterns in Alzheimer's disease patients

Background Benzodiazepines (BZD) are commonly prescribed in the elderly. Persons with dementia may be at a greater risk of adverse reactions of BZD such as cognitive impairment. Objective To assess the prevalence of BZD use in Alzheimer's disease patients and to examine patient and drug-characteristics associated with this use. Design Cross-sectional study. Participants Five thousand community-dwelling and institutionalized patients initiating a treatment with tacrine for a mild to moderate Alzheimer's disease and included in the tacrine-study (Paco cohort). Measurements Patient characteristics and BZD use recorded at the inclusion. Main outcome Use of BZD during the 3 months prior to inclusion. Results The 3-month prevalence of ever use of BZD was 20%. After controlling for age and gender, there was a non-significant inverse association between BZD use and a score of Mini-Mental Status Evaluation (MMSE) below 24 (OR: 0.88, 95%CI: 0.71-1.09), and significant inverse association with an increased number of chronic conditions (OR: 0.73. 95%,CI: 0.58-0.91). Higher use of BZD was associated with higher level of overall drug consumption (OR: 2.3, 95%CI: 1.97-2.80). Conclusion Alzheimer's disease patients are frequently prescribed BZD. A low score of MMSE (<24) is associated with a decreased use of BZD. These results suggest important differences in BZD use patterns among persons with Alzheimer's disease. Copyright (C) 2003 John Wiley Sons, Ltd.