Impact des benzodiazépines sur les fonctions cognitives et le risque de démence. Revue des arguments de causalité issus des études observationnelles

Abstract

Benzodiazepines are a source of well-known adverse reactions related to their pharmacological properties: memory disorders, falls in the elderly, confusion and sedation, drug addiction. The impact of their chronic use on cognitive decline and dementia has been the subject of many studies for two decades. From 25 studies identified in the international literature from 1997 to 2017, the Bradford-Hill causality criteria were systematically applied. Fifteen studies found a statistically significant association with a deleterious effect, two a protective effect and eight did not find any association. The most recent studies using a longer delay to take into account a protopathic bias did not find any association or any dose-effect relationship. The majority of studies suggest impaired cognitive functions for contemporary consumption or those closest to the event being studied. Finally, the biological plausibility remains discussed. The question of the role of benzodiazepines in the onset of dementia remains open, and other studies attempting to limit previous methodological drawbacks should be carried out.