Sept. 27, 2012 -- Seniors who take certain kinds of drugs to treat anxiety or insomnia may be more likely to develop dementia than those who do not, a new study shows。

    2012年9月27日，一項新的研究顯示，服用某種治療焦慮或失眠藥物的老年人可能比那些不服用此類藥物的老年人患癡呆的可能性大。

    Seniors are often prescribed benzodiazepines or similar drugs to help with sleeping problems or anxiety. And even though most of these drugs are only meant to be used for a few weeks or months at a time, the drugs can be habit forming. Studies have found that many older adults stay on them longer, sometimes for years。

    醫(yī)生常常會給老年人開苯二氮或類似的藥物以幫助他們解決睡眠問題或緩解焦慮。即使大部分的這類藥物一次只得使用幾周或幾個月，人們?nèi)詴λ幬锂a(chǎn)生依賴性。研究表明，許多老年人服用這些藥物的時間要更久，有時可達幾年。

    The new study, which is published in the BMJ, compared the risk of dementia in two groups of French seniors -- 95 who were recent users of any of 23 benzodiazepines or similar drugs at the start of the study and 968 who were not。

    發(fā)表在《英國醫(yī)學(xué)雜志》（BMJ）上的新研究對兩組法國老年人患癡呆的可能性進行了比較，其中一組是由95位在此項研究開始的近期使用了23種苯二氮中任何一種或類似藥物的老人組成，另一組則是由968位未使用此類藥物的老人組成。

    During the next 15 years, doctors diagnosed 253 cases of dementia. Thirty people （32%） who had taken benzodiazepines or similar drugs developed memory loss and difficulty thinking, compared to 223 people （23%） who had not taken them. Drugs used by people in this study included Ambien, Halcion, Klonopin, Restoril, Valium, and Xanax。

    在接下來的15年中，醫(yī)生診斷出253例癡呆病例。服用苯二氮或類似藥物的人中30人（32％）出現(xiàn)記憶喪失或思考困難，與之相比，未服用藥物的人中223人（23％）出現(xiàn)相同癥狀。此項研究中人們服用的藥物包括安比恩、海樂神、氮硝西泮制劑、替馬西泮膠囊、安定以及阿普唑倉。

    Even after accounting for other things that are known to affect brain function, like age, living alone, depression, high blood pressure, and diabetes, researchers found that seniors who took benzodiazepines were about 60% more likely than those who didn't to develop dementia。

    甚至在考慮到其他已知的影響大腦功能的因素（如年齡、獨自生活、抑郁、高血壓、糖尿?。┲?，研究人員發(fā)現(xiàn)，服用苯二氮的老年人患癡呆的可能性要比那些未服藥的老年人患癡呆的可能性高約60％。

    Association, Not Cause

    相關(guān)，但并非原因

    The study doesn't prove that benzodiazepines cause declines in memory and brain function. And researchers say very short-term use of the drugs is probably safe。

    此研究并未證明，苯二氮是造成記憶減退和大腦功能衰退的原因。并且研究人員表示，在非常短的時期內(nèi)使用這種藥物可能是安全的。

    But other experts say seniors may want to avoid the drugs altogether。

    但是其他專家稱，老年人應(yīng)該要完全避免使用這種藥物。

    “There is a growing body of evidence that the use of benzodiazepines is a risk factor for poor [brain function] in older adults,” says Cara Tannenbaum, MD, of the University of Montreal in Canada。

    加拿大蒙特利爾大學(xué)（University of Montreal）醫(yī)學(xué)博士（MD）卡拉 坦嫩鮑姆（Cara Tannenbaum）說：“越來越多的證據(jù)表明，使用苯二氮是老年人大腦功能衰退的一個危險因素”。

    Tannenbaum has recently reviewed evidence that supports a link between benzodiazepines and dementia, but she was not involved in the current research。

    坦嫩鮑姆最近回顧了支持苯二氮和癡呆二者之間存在聯(lián)系的證據(jù)，但她并未參與到目前的這項研究。

    “In my opinion there is a very definite cause for concern, not only because of obvious memory impairment but because of the well-documented risk of falls and car accidents,” she says。

    她說：“在我看來，人們有非常明確的理由需要對此表示擔憂，不僅是因為記憶明顯減退，還因為發(fā)生跌倒和車禍的風險增加，這一點證據(jù)充分”。

    A Mixed Bag

    各種觀點的匯集

    Two previous studies found that benzodiazepine users had no increased risk, or perhaps even a decreased risk of dementia, compared to seniors who didn't take the drugs。

    先前的兩項研究發(fā)現(xiàn)，與不使用苯二氮的老年人相比，使用苯二氮不會增加患癡呆的幾率，甚至也許可能會降低患癡呆的幾率。

    Three other studies, on the other hand, have noted increased risks for memory trouble in benzodiazepine users。

    另一方面，其他的三項研究指出，苯二氮使用者出現(xiàn)記憶問題的幾率會增加。

    Those studies followed people for shorter periods of time, so they couldn't rule out the possibility that people had started taking the drugs to relieve the first symptoms of dementia, which often include increased anxiety, agitation, and trouble sleeping。

    上面提及的這幾項研究對人們只進行了短期的跟蹤調(diào)查，所以不排除人們此前曾使用過緩解癡呆早期癥狀的藥物，這些早起癥狀包括焦慮增加、興奮以及睡眠困難。

    The new study got around that problem by following study participants for five years before they were even considered for the analysis. This allowed researchers to exclude people who were showing signs of memory problems before they started the drugs。

    甚至在研究參與者還未被確定為分析對象前就對他們進行了為期五年的跟蹤調(diào)查，通過這一做法，這項新研究解決了這一問題。而這一做法讓研究人員將那些用苯二氮等藥物前就表現(xiàn)出記憶問題的人們排除在外。

    Researchers say the study leaves many questions unanswered. For example, they don't know how benzodiazepines may lead to dementia. And they don't know whether their results might apply to younger people。

    研究人員稱，這項研究仍留下學(xué)多問題有待解決。例如，他們并不清初苯二氮如何導(dǎo)致癡呆。他們也不并不清初他們的研究結(jié)果是否可以應(yīng)用在年輕人身上。

    “We don't have a single study on this topic conducted in younger patients. We don't know if the risk of dementia is increased in people who use the drugs when they are younger -- at age 40 or 45,” says researcher Bernard Begaud, MD, PhD, a professor of pharmacology at the University of Bordeaux in France。

    研究人員之一、來自法國波爾多大學(xué)（the University of Bordeaux）的藥理學(xué)教授、醫(yī)學(xué)博士伯納德 伯高德（Bernard Begaud）說：“我們沒有一項針對這一問題的研究是在年輕病人身上進行的。我們不清楚在較為年輕時（年齡在40到45歲之間））就使用這類藥物的人患癡呆的幾率是否會增加”。

    But based on all the available evidence, Begaud says seniors may want to seek out alternatives to benzodiazepines, especially if they've been on the drugs for a long time。

    但是基于所有可獲得的證據(jù)，伯高德表示，老年人應(yīng)當尋求苯二氮的替代藥物，尤其在他們已經(jīng)長時間使用這類藥物的情況下。

    “Many elderly patients take them for sleep disorders, but they might have trouble sleeping because they are depressed and they need treatment for depression, or they are drinking coffee too late in the day or they aren't exercising,” he says。

    他說：“許多老年病人因為失眠而服用它們，但是他們睡眠出現(xiàn)問題可能是因為他們抑郁，因此他們需要治療抑郁，或者因為他們在一天中太晚的時候喝了咖啡，或者因為他們不進行鍛煉”。