Association Between Benzodiazepines and Dementia in South Korea: A Nation-Wide Study

Objective: Benzodiazepines are a widely used class of medications for anxiety, depression, and insomnia. Despite their common use, concerns remain about memory problems with benzodiazepines. Despite the growing financial and social burden of dementia, inconsistent results persist regarding the association between benzodiazepines and dementia. Therefore, we aimed to evaluate the association between benzodiazepines and dementia in Korea. Methods: Diagnostic and prescription information from the Health Insurance Review and Assessment (HIRA) database in South Korea between 2009 and 2014 was utilized. The dementia group included people who were diagnosed with a dementia code and received one or more prescriptions for dementia. A total of 68,241 participants with dementia and 341,205 control participants were matched. Possible confounders, such as major medical and psychiatric disorders, were adjusted, and multivariate logistic regression was conducted to assess the association between benzodiazepines and dementia. Results: The highest odds ratio (OR) for dementia was noted for clonazepam (OR=2.86, 95% confidence interval [CI]=2.77-2.95) followed by those for diazepam (OR=2.60, 95% CI= 2.53-2.66), lorazepam (OR=1.34, 95% CI=1.30-1.37), and triazolam (OR=1.26, 95% CI=1.21-1.32). Conclusion: Overall, relatively long-acting benzodiazepines, such as clonazepam, diazepam, and lorazepam, were associated with the incidence of dementia. Triazolam, which is approved for insomnia, was also significantly associated with dementia. Individuals who are prescribed with benzodiazepines should be cautious regarding memory loss and dementia. Further studies are needed to confirm the temporal and biological causality between benzodiazepines and dementia.