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

Original Article

Abstract

Background: Among elderly patients with the 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 serious effects on cognition. The main purpose of the current research is to determine a comparative rate of dementia in elderly patients on benzodiazepines or non-benzodiazepine anxiolytics.

 Objectives: First of all, the efficacy of benzodiazepine and non-benzodiazepine anxiolytics will be compared with helping of short-time memory, attention, and main executive abilities in the elderly patients.

 Study Design: A Observational prospective cohort study

 Place and Duration of Study: Department of Pharmacy, Lady Reading Hospital-Peshawar, starting from: 05 January 2021 till: 05 July 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 patients’ cognitive function was evaluated by Mini-Metal State Examination (MMSE), 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 years standard deviation. The results of systematically 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 score 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 the 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