Background: Benzodiazepines are a widely used medication in developed countries, particularly among elderly patients. However, benzodiazepines are known to affect memory and cognition and might thus enhance the risk of dementia. The objective of this review is to synthesize evidence from observational studies that evaluated the association between benzodiazepines use and dementia risk. Summary: We performed a systematic review and meta-analysis of controlled observational studies to evaluate the risk of benzodiazepines use on dementia outcome. All control observational studies that compared dementia outcome in patients with benzodiazepine use with a control group were included. We calculated pooled ORs using a random-effects model. Ten studies (of 3,696 studies identified) were included in the systematic review, of which 8 studies were included in random-effects meta-analysis and sensitivity analyses. Odds of dementia were 78% higher in those who used benzodiazepines compared with those who did not use benzodiazepines (OR 1.78; 95% CI 1.33-2.38). In subgroup analysis, the higher association was still found in the studies from Asia (OR 2.40; 95% CI 1.66-3.47) whereas a moderate association was observed in the studies from North America and Europe (OR 1.49; 95% CI 1.34-1.65 and OR 1.43; 95% CI 1.16-1.75). Also, diabetics, hypertension, cardiac disease, and statin drugs were associated with increased risk of dementia but negative association was observed in the case of body mass index. There was significant statistical and clinical heterogeneity among studies for the main analysis and most of the sensitivity analyses. There was significant statistical and clinical heterogeneity among the studies for the main analysis and most of the sensitivity analyses. Key Messages: Our results suggest that benzodiazepine use is significantly associated with dementia risk. However, observational studies cannot clarify whether the observed epidemiologic association is a causal effect or the result of some unmeasured confounding variable. Therefore, more research is needed.
1 October 2021 in Computer Methods and Programs in Biomedicine
Background: 21 million girls get pregnant every year. Many initiatives are empowering girls. Various studies have looked at girl empowerment, however, there is contradicting evidence, and even less literature from developing countries. Methods: We searched articles published between January 2000 to January 2019. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered our protocol on the International Prospective Register of Systematic Reviews PROSPERO (CRD42019117414). Nine articles were selected for review. Quality appraisal was done using separate tools for qualitative studies, cohort and cross-sectional studies and randomized control trials. Results: Eight studies included educational empowerment, four studies included community empowerment, three studies included economic empowerment, while two studies discussed policy empowerment. Three studies were of fair quality; two qualitative and one cross-sectional study were of high quality, while three studies had low quality. Discussion. Studies showed a favorable impact of girl empowerment on adolescent pregnancies and risky sexual behaviors. Education empowerment came through formal education or health systems such as in family planning clinics. Community empowerment was seen as crucial in girls’ development, from interactions with parents to cultural practices. Economic empowerment was direct like cash transfer programs or indirect through benefits of economic growth. Policies such as contraceptive availability or compulsory school helped reduce pregnancies.
1 August 2020 in Computer Methods and Programs in Biomedicine