{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:11:13Z","timestamp":1790683873457,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,11,15]],"date-time":"2017-11-15T00:00:00Z","timestamp":1510704000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Geriat Psychiatry"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the risk of death associated with new benzodiazepine and related drug (BZDR) use in a nationwide cohort of persons with Alzheimer disease (AD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The register\u2010based MEDALZ cohort, including all community\u2010dwelling Finns diagnosed with AD during 2005 to 2011 (n\u00a0=\u00a070\u00a0718), was used. Clinically verified AD diagnoses were obtained from the Special Reimbursement Register. Drug use periods were modeled from BZDR purchases, derived from the Prescription Register. To study new users, persons who had any BZDR use during the year preceding the AD diagnosis were excluded.<\/jats:p><jats:p>For each person initiating BZDR use (n\u00a0=\u00a010\u00a0380), 2 nonusers (n\u00a0=\u00a020\u00a0760) were matched on age, gender, and time since AD diagnosis. The outcome was 180\u2010day mortality, and BZDR use was compared with nonuse with Cox regression. Multivariable analyses were adjusted for Charlson comorbidity index, socioeconomic position, hip fractures, psychiatric disorders, substance abuse, stroke, and other psychotropic drug use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the follow\u2010up, 5 excess deaths per 100 person\u2010years occurred during BZDR use in comparison to nonuse, and mortality rates were 13.4 (95% confidence interval [CI], 12.2\u201014.5) and 8.5 (95% CI, 7.9\u20109.1), respectively. Benzodiazepine and related drug use was associated with an increased risk of death (adjusted hazard ratio\u00a0=\u00a01.4 [95% CI, 1.2\u20101.6]), and the association was significant from the initiation of use. Benzodiazepine use was associated with an increased risk of death, whereas benzodiazepine\u2010related drug use was not.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Benzodiazepine and related drug use was associated with an increased risk of death in persons with AD. Our results support treatment guidelines stating that nonpharmacological approaches should be the first\u2010line option for symptomatic treatment of AD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/gps.4821","type":"journal-article","created":{"date-parts":[[2017,11,16]],"date-time":"2017-11-16T04:26:41Z","timestamp":1510806401000},"page":"583-590","source":"Crossref","is-referenced-by-count":32,"title":["Risk of death associated with new benzodiazepine use among persons with Alzheimer disease: A matched cohort study"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2542-8137","authenticated-orcid":false,"given":"Laura","family":"Saarelainen","sequence":"first","affiliation":[{"name":"Kuopio Research Centre for Geriatric Care University of Eastern Finland  Kuopio Finland"},{"name":"School of Pharmacy University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna\u2010Maija","family":"Tolppanen","sequence":"additional","affiliation":[{"name":"School of Pharmacy University of Eastern Finland  Kuopio Finland"},{"name":"Research Centre for Comparative Effectiveness and Patient Safety University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjaana","family":"Koponen","sequence":"additional","affiliation":[{"name":"Kuopio Research Centre for Geriatric Care University of Eastern Finland  Kuopio Finland"},{"name":"School of Pharmacy University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antti","family":"Tanskanen","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"},{"name":"Impact Assessment Unit National Institute for Health and Welfare  Helsinki Finland"},{"name":"Department of Forensic Psychiatry Niuvanniemi Hospital  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jari","family":"Tiihonen","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Forensic Psychiatry Niuvanniemi Hospital  Kuopio Finland"},{"name":"Stockholm County Council  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirpa","family":"Hartikainen","sequence":"additional","affiliation":[{"name":"Kuopio Research Centre for Geriatric Care University of Eastern Finland  Kuopio Finland"},{"name":"School of Pharmacy University of Eastern Finland  Kuopio Finland"},{"name":"Department of Psychiatry Kuopio University Hospital  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Taipale","sequence":"additional","affiliation":[{"name":"Kuopio Research Centre for Geriatric Care University of Eastern Finland  Kuopio Finland"},{"name":"School of Pharmacy University of Eastern Finland  Kuopio Finland"},{"name":"Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,15]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"World Alzheimer Report 2015","author":"Alzheimer's Disease International","year":"2015"},{"key":"e_1_2_7_3_1","first-page":"481","article-title":"Burden of Alzheimer's disease and association with negative health outcomes","volume":"15","author":"Malone DC","year":"2009","journal-title":"Am J Manag Care"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2014.10.005"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2017.02.001"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0059124"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afq146"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-2012-120808"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-011-0147-9"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/JGP.0b013e3181d6b68d"},{"key":"e_1_2_7_11_1","first-page":"5","article-title":"American Psychiatric Association practice guideline for the treatment of patients with Alzheimer's disease and other dementias. 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