Comparative Study of Cognitive Decline in Elderly Patients Using Benzodiazepine vs. Non-Benzodiazepine Anxiolytics

Original Article

Abstract

Background: Among elderly patients with anxiety disorders, anxiolytic prescriptions, including benzodiazepines and non-benzodiazepine sedative agents, are frequently used. However, these medications are known to have the risk of having profound effects on cognition. The primary purpose of the current research is to determine a comparative rate of dementia in elderly patients on benzodiazepines or non-benzodiazepine anxiolytics.

Objectives: to find the efficacy of benzodiazepine and non-benzodiazepine anxiolytics will be compared to the help of short-term memory, attention, and primary executive abilities in elderly patients.

Study Design: An observational prospective cohort study

Place and Duration of Study: Department of Pharmacy Lady Reading Hospital-Peshawar, starting from January 05 January 05, 2021, till July 05 July 05, 2022.

Methods: This study was conducted on 150 elderly patients provided with either benzodiazepines or non-benzodiazepine anxiolytics with equal division of the groups into 75 each. The patient's cognitive function was evaluated by Mini-Metal State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) at the beginning and after six months of medication. The participants' demographic characteristics showed that the mean age was 70. 5 years, with 5. 3-year standard deviation. The results of systematic cognitive tests were analyzed with one-way ANOVA to compare them, while 'p-value less than 0. 05' was established as significant.

Results: Compared with non-benzodiazepine anxiolytics users, the patients on benzodiazepines received lower cognitive scores. Pre and post-intervention mean MMSE scores in the benzodiazepine group were 26. 2(± 2. 0), 22. 8 (± 2. 9) respectively

(t= 6. 245; p < 0. 01) and non-benzodiazepine groups 26. 5 (± 2. 1), 24. 7 (± 2. 7) respectively (t = Likewise, pre-treatment and post-treatment mean MoCA scores for the benzodiazepine group were 24. 4 (± 2. 3) and 20. 9 (± 2. 6), respectively, and for the non-benzodiazepine group, the scores were respectively 24. 8 (± 2. 4) and 22. 5 (± 2. 5).

Conclusions: Benzodiazepine is more clinically linked with an increased rate of cognitive decline in elderly patients as compared to non-benzodiazepine anxiolytics. Therefore, these results support the use of treatment precautions when using anxiolytics for elders and weighing the possibility of reducing anxiety with the potential of yielding short-term memory loss.

Keywords: cognitive performance; Anxiolytics, elderly.