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Benzos increase pneumonia risk in dementia patients

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Benzodiazepines are associated with an increased risk of pneumonia when used in patients with Alzheimer disease, according to a Finnish study.

The study authors noted that dementia was a risk factor for pneumonia and that many people with the condition were prescribed sedatives, such as benzodiazepines and non-benzodiazepines.

“Benefits and risks of the use of benzodiazepines should be carefully considered”

Study authors

To determine if there is a link between such drugs and pneumonia, the researchers looked at data on 49,484 adults diagnosed with Alzheimer’s disease between 2005 and 2011 in Finland.

They matched 5,232 patients taking benzodiazepines and 3,269 patients taking non-benzodiazepines, with the remainder not taking either drug.

They found that benzodiazepines were linked to a 30% increased risk of pneumonia in patients with Alzheimer’s disease, and the risk was highest during the first 30 days of treatment.

The authors, from the University of Eastern Finland, suggested the sedative nature of benzodiazepines may heighten the risk of pneumonia by increasing the aspiration of saliva or food into the lungs.

The results are consistent with studies that have found an increased risk of pneumonia in patients of all ages taking benzodiazepines, they said in the Canadian Medical Association Journal.

“Benefits and risks of the use of benzodiazepines should be carefully considered for patients with Alzheimer’s disease and include risk of pneumonia,” the study authors added.

In a related commentary in the same journal, Dr Paula Rochon from Women’s College Hospital and the University of Toronto, said the study was a “good reminder to clinicians to ‘first do no harm’ when prescribing these drugs for frail older women and men with dementia”.

She added: “Non-pharmacologic approaches should be the starting point when managing neuropsychiatric symptoms in this patient population, which should help to limit inappropriate use of these drugs.”

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