Prolonged use of Benzodiazepines and development of dementia: what the literature says

Abstract

Introduction: Benzodiazepines are a class of medications widely used in the treatment of anxiety disorders, insomnia, and other central nervous system-related conditions. In this context, epidemiological and clinical studies have investigated the relationship between prolonged use of benzodiazepines and cognitive decline, suggesting that these medications may contribute to the development of dementia. This article reviews the existing literature on the subject, aiming to assess the relationship between prolonged benzodiazepine use and the development of dementia, highlighting the underlying mechanisms and clinical implications. Methodology: This is an integrative review on the proposed topic, based on full scientific articles in Portuguese or English, sourced from databases such as PubMed, SciELO, Virtual Health Library, and others, within the time frame from 2000 to 2024. Health Sciences Descriptors (DeCS) were used to select the studies that best fit the research. Results and Discussion: Initially, most cohort and case-control studies identified a positive association between prolonged benzodiazepine use and an increased risk of developing dementia. Systematic reviews, in turn, consistently pointed to the existence of a potential risk but highlighted the difficulty of establishing a definitive causal relationship due to methodological issues in the primary studies, such as indication bias. These results, therefore, support the concern that prolonged use of benzodiazepines may be associated with the development of dementia, especially in elderly populations. However, given that most studies are observational in nature, it is difficult to infer a direct causal relationship. Conclusion: Although the literature suggests an association between prolonged use of benzodiazepines and the development of dementia, the evidence is not yet conclusive due to the methodological limitations of the available studies. Thus, further, more comprehensive and scientifically supported studies are needed to better elucidate this relationship.