Dementia (especially Alzheimer’s) is an increasing problem in America. By age 65, 10% will have dementia; by age 75, 20% will have dementia; and by age 85, 50% will have dementia. The experts claim one in nine baby boomers currently have dementia – a few diagnosed, many undiagnosed – with the number growing daily. But there is hope. We can identify many of the habits that are linked to an increased risk of dementia. One of those habits is the use of benzodiazepines for anxiety, depression, and insomnia.
There are a sizable number of studies that have demonstrated a key factor: the longer your use of a benzodiazepine, the greater your risk of dementia. If you have taken benzodiazepines on a daily basis for 3-6 months, your risk for dementia has increased 32%. If you have taken benzodiazepines on a daily basis for longer than 6 months, your risk for dementia has increased 84%. The negative impact of the use of benzodiazepine on cognitive function is cumulative. The longer you have taken one of those drugs, the higher your chance for developing dementia.
One benzodiazepine does not equal another. The longer acting benzodiazepines, like Valium for anxiety or Dalmane for sleep, are worse for your risk of dementia than the shorter acting benzodiazepines, like Ativan or Xanax for anxiety or Restoril for sleep. However, the recommendation is obvious. If you take any of these benzodiazepines on a daily basis, you should stop that habit. That recommendation goes for everyone, regardless of age, although studies show the negative, cognitive effects of benzodiazepines become more pronounced with use at an older age.
There are several important points that need to be understood. The studies link daily, continuous use of benzodiazepines with the risk of dementia. There are no studies that link intermittent use of benzodiazepines with the risk for dementia. So, the individual who uses a periodic Valium for anxiety, or a periodic Xanax for panic attacks, or a periodic Restoril for intermittent insomnia is not increasing the risk of dementia. The risk for dementia develops only with continuous benzodiazepine use; and the risk for dementia rises with long-term use, not short-term use.
There is another important point. There are no studies claiming benzodiazepines directly cause dementia. The studies only reveal a link between continuous usage of benzodiazepines and the risk for the development of later cognitive deficits. What are the causes of dementia? Some experts assert the real causes, the real links, are the symptoms that are driving you to take a benzodiazepine during the day or a sleeping pill at night. However, I have a slightly different interpretation on the causal relationship between the use of benzodiazepines and the risk of dementia.
I think the causal relationship is shared: i.e., the use of benzodiazepines is a key contributing factor, but not the only factor. Your body needs rejuvenation and repair on a nightly basis. In many ways your body needs to be awake while you are asleep. We have 90 minute sleep cycles throughout the night; and for part of the sleep cycle, your brain physiology needs to be active. Certain neurochemical activities need to be occurring within your brain cells. Certain physiologic changes, directed by an active brain, need to be ongoing for repair while you sleep. Remember how we thought of the brain as static? We now view the brain as showing immense neuroplasticity with the ability to renew cells, reboot physiology, and correct DNA mutations — when it is given the chance.
From my perspective, the actions of the benzodiazepines have a negative impact on slowing down your brain, your physiologic repair, and your DNA repair, thereby making your brain less able to complete full physiologic repair while you sleep. By the way, don’t kid yourself. Alcohol acts in the same manner. It reduces your brain’s chance for rejuvenation and repair. Like benzodiazepine use, alcohol use leads to dementia. But there is the other, equally important, causal factor. What is causing you to take the benzodiazepines? What is causing you to drink alcohol? What is making you anxious and depressed during the day, and unable to fall asleep or stay asleep at night? In short, what is causing the high levels of stress in your life?
With this predicament, you can probably see what needs to be done. First, you need to stop your dependence on benzodiazepines. The same applies for alcohol. Here is my recommendation. Since I do not know your specific medication, here is a general suggestion. Cut your current dose of any benzodiazepine by 50% for 10 days, the cut that dose by another 50% for the next 10 days, then reduce that dose by 50% for the final 10 days, and then discontinue the benzodiazepines completely. Unless you are taking a massive dose, the slow tapering over a month should be sufficient to safely wean you free from the benzodiazepines without any acute, serious withdrawal symptoms, abnormal blood pressure, or disastrous consequences.
There remains a bigger task while you are tapering off of the benzodiazepines. You need to identify the reasons why you take those medications. You need to also know what causes you to drink alcohol. You need to clarify the stressors in your life. Then you need to change those stressors or change how you handle those stressors. Are you ready for a major change in your life? Too many people say ‘yes’ when they are really not ready for real change. To be certain of your self-assessment for initiating a life-altering change, take the shape quiz from my earlier blog in August 2014. Just scroll back through the pages/ blogs and retake the quiz. If you are ready for a change, it will give you the answer of where you need to change! However, if you are not ready for change, ask for some help from a spouse, a friend, even a therapist, to better identify the change and prepare you for the change.
Here is the reality. To eliminate the need for the use of benzodiazepines, you need to tackle those causal factors, reducing or eliminating them. Again, the same goes for alcohol abuse. For most people, it is not easy to eliminate prescriptions drugs or self-medicating drugs (alcohol). Many times you need to take some risks, breaking free from your current work or your current position or your current relationship. But something has to change in your life. Personally, as someone who believes we live from the inside out, I suggest you change yourself first, then address the remaining external factors. Sometimes stress can be reduced just by refocusing your attention on the things that truly matter in life, including your needs, your wants, and your passions. We will get to all of those points in the upcoming blogs.
Now, if you make these changes, can the risk of dementia be reduced?
The answer is yes. Even the damage can be reversed.