Abstract
This study examined the association between benzodiazepine (BZD) use and behavioral and psychological symptoms of dementia (BPSD), activities of daily living (ADL), and caregiver-related outcomes among older adults with dementia in institutional settings. A cross-sectional study was conducted in psychiatric hospitals and long-term care facilities, and data from 49 patient–caregiver pairs were analyzed. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), ADL using the Katz Index, and BPSD and caregiver-related outcomes using the Neuropsychiatric Inventory–Nursing Home version (NPI-NH). Between-group comparisons were performed for patients receiving BZDs and those not receiving BZDs, and analysis of covariance (ANCOVA) adjusted for age, sex, facility type, and MMSE score. Approximately one-third of participants were prescribed benzodiazepines. No significant differences were observed between groups in MMSE, Katz Index, or NPI-NH total severity scores. In unadjusted analyses, the BZD group showed significantly higher occupational disruptiveness scores. However, this association was no longer significant after adjustment for the covariates. These findings indicate that BZD use was not significantly associated with cognitive function, BPSD severity, or ADL. The initially observed difference in occupational disruptiveness may reflect underlying patient or care-related factors rather than an independent medication effect. Given the cross-sectional design and small sample size, the findings should be interpreted as exploratory. Larger longitudinal studies incorporating multidimensional caregiver burden measures are needed to clarify the clinical and organizational implications of BZD use in dementia care.
https://ror.org/0036wzx44 
