https://scholars.lib.ntu.edu.tw/handle/123456789/484652
標題: | Risk of Dementia in Patients with Insomnia and Long-term Use of Hypnotics: A Population-based Retrospective Cohort Study | 作者: | Chen, P.-L. Lee, W.-J. WEI-ZEN SUN Oyang, Yen-Jen Fuh, Jong-Ling |
公開日期: | 2012 | 卷: | 7 | 期: | 11 | 來源出版物: | PLoS ONE | 摘要: | Background: Hypnotics have been reported to be associated with dementia. However, the relationship between insomnia, hypnotics and dementia is still controversial. We sought to examine the risk of dementia in patients with long-term insomnia and the contribution of hypnotics. Methods: Data was collected from Taiwan's Longitudinal Health Insurance Database. The study cohort comprised all patients aged 50 years or older with a first diagnosis of insomnia from 2002 to 2007. The comparison cohort consisted of randomly selected patients matched by age and gender. Each patient was individually tracked for 3 years from their insomnia index date to identify whether the patient had a first diagnosis of dementia. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: We identified 5693 subjects with long-term insomnia and 28,465 individuals without. After adjusting for hypertension, diabetes mellitus, hyperlipidemia, and stroke, those with long-term insomnia had significantly higher risks of dementia (HR, 2.34; 95% CI, 1.92-2.85). Patients with long-term insomnia and aged 50 to 65 years had a higher increased risk of dementia (HR, 5.22; 95% CI, 2.62-10.41) than those older than 65 years (HR, 2.33; 95% CI, 1.90-2.88). The use of hypnotics with a longer half-life and at a higher prescribed dose predicted a greater increased risk of dementia. Conclusions: Patients with long-term use of hypnotics have more than a 2-fold increased risk of dementia, especially those aged 50 to 65 years. In addition, the dosage and half-lives of the hypnotics used should be considered, because greater exposure to these medications leads to a higher risk of developing dementia. ? 2012 Chen et al. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/484652 | DOI: | 10.1371/journal.pone.0049113 | SDG/關鍵字: | clonazepam; flurazepam; nordazepam; zaleplon; zolpidem; zopiclone; adult; age distribution; aged; article; cerebrovascular accident; cohort analysis; controlled study; dementia; diabetes mellitus; disease association; drug half life; female; gender; high risk patient; human; hyperlipidemia; hypertension; insomnia; long term care; major clinical study; male; proportional hazards model; retrospective study; risk assessment; Taiwan; Aged; Cohort Studies; Dementia; Female; Humans; Hypnotics and Sedatives; Male; Middle Aged; Proportional Hazards Models; Retrospective Studies; Risk Factors; Sleep Initiation and Maintenance Disorders; Taiwan |
顯示於: | 生醫電子與資訊學研究所 |
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