Cheng HT, et al. - This retrospective cohort study assessed the link between zolpidem use and the risk of Alzheimer's disease among older people. In Taiwanese elderly subjects consuming a high cumulative dose of zolpidem, the risk of Alzheimer's disease was reported to be increased and, hence, caution should be exercised when considering long-term use of zolpidem in older patients.

Methods

• A retrospective cohort study was performed in Taiwan using data from 2001 to 2011 from the National Health Insurance Research Database.
• From January 2002 to December 2004, a total of 6,922 patients aged 65 years or older were enrolled.
• Researchers identified zolpidem users as patients who used zolpidem during the enrollment period.
• The index date was the date of the first zolpidem prescription.
• Dosage of zolpidem use was defined using cumulative defined daily dose (cDDD) based on the cumulative dosage that patients took within one year after the index date (grouped as: less than 28, 28–90, 91–180, and more than 180 cDDD).
• The occurrence of Alzheimer's disease was defined as the time period from the end of one year after the index date to the date of the Alzheimer's disease diagnosis.
• They used propensity score to adjust the measured confounders of Alzheimer's disease.
• They also used Cox proportional hazards models to assess the link between zolpidem use and the incidence of Alzheimer's disease.

Results

• Researchers observed that zolpidem users with a high cumulative dose (>180 cDDD) in the first year after initiation had a significantly greater risk of Alzheimer's disease than non-zolpidem users (HR = 2.97, 95% CI = 1.61–5.49) and low cumulative dose (<28 cDDD) users (HR = 4.18, 95% CI = 1.77–9.86).