Commonly Used Sedatives Linked to Pneumonia Risk in Alzheimer’s Patients

Highlights

• Alzheimer’s disease is a neurodegenerative disorder and is the most common type of dementia.
• New study finds commonly used benzodiazepine sedatives to be associated with increased risk of pneumonia in patients with Alzheimer’s disease.
• Dementia in Alzheimer’s patients may cause aspiration pneumonia when the food or saliva reaches the windpipe instead of reaching the food pipe.

Benzodiazepine sedatives are often associated with increased risk of pneumonia in patients with Alzheimer’s disease, finds a recent study published in Canadian Medical Association Journal. Alzheimer’s disease is a neurodegenerative disorder and around 60-70% of cases are due to dementia. It is estimated that around 5 million Americans are living with Alzheimer’s disease.These people are prescribed with benzodiazepines and nonbenzodiazepine drugs, both of which have sedative effects.

Dr. Heidi Taipale, Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland with authors, said, "An increased risk of pneumonia is an important finding to consider in treatment of patients with Alzheimer disease."

"Benzodiazepines and non-benzodiazepine drugs (Z-drugs) are frequently prescribed for this population, and long-term use is typical. Pneumonia often leads to admission to hospital, and patients with dementia are at increased risk of death related to pneumonia."

Link Found Between Alzheimer’s Drugs and Pneumonia
The research team looked at the data collected from national registries on 49,484 adults who were living in the community with Alzheimer’s disease between 2005 to 2011 in Finland.

The subjects were about 80 years old and around 62.7% of them were women. Of these people around 5232 patients were taking benzodiazepine drugs and 3269 patients took nonbenzodiazepine drugs while the remaining people did not take any drugs.

Study Findings
The findings of the study depicted that

• People who took benzodiazepines were associated with 30% increased risk of pneumonia in patients with Alzheimer’s disease.
• The risk was the highest when taken at the start of the treatment.

Even though there was no significant association with nonbenzodiazepine drugs and pneumonia, the authors did not conclude that they were safe as they did not compare nonbenzodiazepines and benzodiazepine drugs.

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The research team found that the sedative nature of benzodiazepines could increase the risk of pneumonia by raising the aspiration of food or saliva into the lungs.

The author finally concludes that, "Benefits and risks of the use of benzodiazepines should be carefully considered for patients with Alzheimer disease and include risk of pneumonia."

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What are Sedatives?
Sedatives are drugs that are found to depress the central nervous system. Benzodiazepines, barbiturates are some sedatives that are prescribed for treating anxiety, insomnia and other conditions.

Examples

• Benzodiazepines - Lorazepam, diazepam, clonazepam
• Barbiturates - Phenobarbital, secobarbital, mephobarbital

Pneumonia Risk in Alzheimer’s Patients
Pneumonia causes serious infection in the upper respiratory tract. It usually occurs in people who have a weakened immune system, or health conditions like Alzheimer’s disease or dementia.

Aspiration pneumonia occurs more commonly in Alzheimer’s patients due to dysphagia condition which causes difficulty in swallowing. The food reaches the windpipe instead of going into the food pipe.

It is considered to be one of the most common cause death among Alzheimer’s patients.

Symptoms of Pneumonia

• Cough
• Breathing difficulty
• Fever
• Rapid heartbeat

References

1. HeidiTaipalePhD Pharm et.al 'Risk of pneumonia associated with incident benzodiazepine use among community-dwelling adults with Alzheimer disease', CMAJ2017 April 10;189:E519-29 doi: 10.1503/cmaj.160126
2. 2017 Alzheimer's Disease Facts and Figures - ( http://www.alz.org/facts/)
3. Sedatives and Tranquilizers - ( http://www.mass.gov/eohhs/gov/departments/dph/programs/substance-abuse/stop-pill-abuse/drug-facts/sedatives-and-tranquilizers.html)
4. What causes pneumonia in people with dementia? - ( https://www.unforgettable.org/blog/what-causes-pneumonia-in-people-with-dementia/)

Source-Medindia