![]() ![]() Thus, the relationship between the use of zolpidem and the potential risk of developing dementia remains unknown. 15 However, there are limited clinical data concerning the effects of long-term zolpidem use on psychomotor or cognitive functions. A 3-week clinical trial revealed psychomotor retardation in 2% of patients receiving zolpidem and in 0% of patients in the placebo group. 13, 14 The most frequent adverse effects associated with zolpidem are nausea, headache, dizziness, drowsiness, hallucination, and short-term memory loss. 13 Zolpidem is well known for having a rapid onset (usually several minutes), short duration of action (the peak time is 2 hours, half time is 1.5–5.5 hours), low tolerance, and a low incidence of adverse effects in treating insomnia. Zolpidem acts as an agonist of the benzodiazepine ω1 receptor component of the GABA A receptor complex and is commonly used in patients with insomnia, including elderly patients. Zolpidem and its derivatives (the Z drugs) are non-BZD hypnotic agent belonging to the imidazopyridine family. 8– 12 However, the possibility that zolpidem used independently of benzodiazepine derivatives, increases the risk for dementia has not been proposed. ![]() 7 The results of previous studies have suggested that BZDs are associated with an increased risk of dementia in the elderly population, and these risks decreased when BZD use is discontinued. 6 Benzodiazepine (BZD) and other non-selective γ-aminobutyric acid (GABA) agonists with hypnotic effects similar to those of zolpidem have been shown to disrupt the memory in both human participants and animal subjects. The risk factors for dementia include an apolipoprotein E4 genotype, cardiovascular comorbidities, diabetes mellitus, cerebrovascular diseases, alcohol consumption, and a lower education level. 4 Because of an increased life expectancy in modern years, the number of people suffering from dementia has rapidly increased, potentially reaching up to 63 million people by 2030. ![]() 3, 4 The incidence of dementia ranges from approximately 1 per 100 person-years in people aged 60 to 64 years to > person-years in people older than 90 years. An expert panel estimated that the global prevalence of dementia is 3.9% in people over 60 years of age, and the estimated global annual incidence of dementia is approximately 7. 2 Alzheimer disease is the most common dementing disorder, followed by vascular dementia, frontal lobe dementia, and dementia with Lewy bodies. Increased accumulative dose might have higher risk to develop dementia, especially in patients with underlying diseases such as hypertension, diabetes, and stroke.ĭementia is a clinical syndrome characterized by “a global deterioration of mental functioning in its cognitive, emotional, and cognitive aspects.” 1 Dementia typically involves a long period of progressive decline in memory and other cognitive abilities secondary to brain dysfunction and is a major cause of disability in elderly people. Zolpidem used might be associated with increased risk for dementia in elderly population. The adjusted OR for patients whose cumulative exposure doses were between 170 and 819 mg/year (adjusted OR: 1.65, 95% CI 1.08–2.51, P = 0.0199) was significant however, the effects for lower and higher cumulative dose were not significant. In patient with Alzheimer diseases, the effects of zolpidem among patients with Alzheimer's disease remained obscure. Zolpidem use also has significant dose–response effects for most of the types of dementia. Zolpidem alone or with other underlying diseases, such as hypertension, diabetes, and stroke, was significantly associated with dementia after controlling for potential confounders, such as age, sex, coronary artery disease, diabetes, anti-hypertension drugs, stroke, anticholesterol statin drugs, depression, anxiety, benzodiazepine, anti-psychotic, and anti-depressant agents’ use (Adjusted OR = 1.33, 95% CI 1.24–1.41). ![]() The relationship between the average cumulative doses for zolpidem and dementia was also analyzed. The relationships between zolpidem use and dementia were measured using odds and adjusted odds ratios. A total of 8406 dementia and 16,812 control subjects were enrolled from Taiwan NHIRD during 2006 to 2010. Newly diagnosed dementia patients 65 years and older and controls were sampled. We evaluate the effects of zolpidem use to develop dementia or Alzheimer disease from the Taiwan National Health Insurance Research Database (NHIRD).Ī retrospective population-based nested case–control study. ![]()
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