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pt. 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，一项新的研究显示，服用某种治疗焦虑或失眠药物的老年人可能比那些不服用此类药物的老年人患痴呆的可能性大。
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。
医生常常会给老年人开苯二氮或类似的药物以帮助他们解决睡眠问题或缓解焦虑。即使大部分的这类药物一次只得使用几周或几个月，人们仍会对药物产生依赖性。研究表明，许多老年人服用这些药物的时间要更久，有时可达几年。
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。
发表在《英国医学杂志》（BMJ）上的新研究对两组法国老年人患痴呆的可能性进行了比较，其中一组是由95位在此项研究开始的近期使用了23种苯二氮中任何一种或类似药物的老人组成，另一组则是由968位未使用此类药物的老人组成。
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。
在接下来的15年中，医生诊断出253例痴呆病例。服用苯二氮或类似药物的人中30人（32％）出现记忆丧失或思考困难，与之相比，未服用药物的人中223人（23％）出现相同症状。此项研究中人们服用的药物包括安比恩、海乐神、氮硝西泮制剂、替马西泮胶囊、安定以及阿普唑仓。
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。
甚至在考虑到其他已知的影响大脑功能的因素（如年龄、独自生活、抑郁、高血压、糖尿病）之后，研究人员发现，服用苯二氮的老年人患痴呆的可能性要比那些未服药的老年人患痴呆的可能性高约60％。
Association, Not Cause
相关，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。
此研究并未证明，苯二氮是造成记忆减退和大脑功能衰退的原因。并且研究人员表示，在非常短的时期内使用这种药物可能是安全的。
But other experts say seniors may want to avoid the drugs altogether。
但是其他专家称，老年人应该要完全避免使用这种药物。
“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。
加拿大蒙特利尔大学（University of Montreal）医学博士（MD）卡拉 坦嫩鲍姆（Cara Tannenbaum）说：“越来越多的证据表明，使用苯二氮是老年人大脑功能衰退的一个危险因素”。
Tannenbaum has recently reviewed evidence that supports a link between benzodiazepines and dementia, but she was not involved in the current research。
坦嫩鲍姆最近回顾了支持苯二氮和痴呆二者之间存在联系的证据，但她并未参与到目前的这项研究。
“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。
她说：“在我看来，人们有非常明确的理由需要对此表示担忧，不仅是因为记忆明显减退，还因为发生跌倒和车祸的风险增加，这一点证据充分”。
A Mixed Bag
各种观点的汇集
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。
先前的两项研究发现，与不使用苯二氮的老年人相比，使用苯二氮不会增加患痴呆的几率，甚至也许可能会降低患痴呆的几率。
Three other studies, on the other hand, have noted increased risks for memory trouble in benzodiazepine users。
另一方面，其他的三项研究指出，苯二氮使用者出现记忆问题的几率会增加。
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。
上面提及的这几项研究对人们只进行了短期的跟踪调查，所以不排除人们此前曾使用过缓解痴呆早期症状的药物，这些早起症状包括焦虑增加、兴奋以及睡眠困难。
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。
甚至在研究参与者还未被确定为分析对象前就对他们进行了为期五年的跟踪调查，通过这一做法，这项新研究解决了这一问题。而这一做法让研究人员将那些用苯二氮等药物前就表现出记忆问题的人们排除在外。
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。
研究人员称，这项研究仍留下学多问题有待解决。例如，他们并不清初苯二氮如何导致痴呆。他们也不并不清初他们的研究结果是否可以应用在年轻人身上。
“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。
研究人员之一、来自法国波尔多大学（the University of Bordeaux）的药理学教授、医学博士伯纳德 伯高德（Bernard Begaud）说：“我们没有一项针对这一问题的研究是在年轻病人身上进行的。我们不清楚在较为年轻时（年龄在40到45岁之间））就使用这类药物的人患痴呆的几率是否会增加”。
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。
但是基于所有可获得的证据，伯高德表示，老年人应当寻求苯二氮的替代药物，尤其在他们已经长时间使用这类药物的情况下。
“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。
他说：“许多老年病人因为失眠而服用它们，但是他们睡眠出现问题可能是因为他们抑郁，因此他们需要治疗抑郁，或者因为他们在一天中太晚的时候喝了咖啡，或者因为他们不进行锻炼”。
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发表于 2015-6-17 15:50:28
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