Cognitive and balance dysfunctions due to the use of zolpidem in the elderly: a systematic review

Abstract

ABSTRACT. Zolpidem is one of the most widely prescribed hypnotic (non-benzodiazepine) agents for sleep disorder. Recently, an increase in the demand for this drug has been observed, mainly in the elderly population. Objective: This study aims to analyze the acute effect of zolpidem on cognitive and balance dysfunctions in the elderly population. Methods: A study was conducted by two independent researchers in four virtual scientific information bases and included randomized controlled trials. The studies evaluated elderly patients using zolpidem. Cognitive and balance dysfunctions were analyzed. Results: Six articles were included. The mean age of the participants in the studies was 69 years. The following zolpidem dosages were evaluated: 5, 6.25, 10, and 12.5 mg. Comparing zolpidem and placebo, relating to the cognitive dysfunctions, there is no statistically significant difference between the groups. However, in relation to balance dysfunctions, there is a statistically significant difference between the intervention and the comparison, favoring placebo. Conclusions: Zolpidem, even in usual doses (5 mg and 10 mg), has shown to increase the risk for balance dysfunctions. However, this does not occur in relation to cognitive changes.

Physicians’ attitudes toward hypnotics for insomnia: A questionnaire-based study

“…This NMA also reported that although no significant difference was noted in dropout due to adverse events between the eszopiclone and placebo groups, zolpidem and zopiclone had significantly more dropouts due to adverse events than placebo ( 13 ). Furthermore, previous studies have reported that NBZ was associated with side effects such as increased risk of falls ( 19 , 20 ), balance dysfunction ( 21 , 22 ), and increased risk of road traffic crashes, as noted with BZ ( 19 , 22 , 23 ). In addition, a study in Israel reported that NBZ was associated with an increased risk of long-term use of hypnotics compared with BZ ( 24 ).…”

Sedative use and incidence of falls and hip fractures among older adults in an outpatient geriatric clinic

“…Esses medicamentos têm sido associados ao aumento na ocorrência de comprometimento cognitivo, delírio, acidentes automobilísticos, quedas e fraturas entre idosos. 4,5 Entre esses desfechos associados ao uso de sedativos benzodiazepínicos e drogas Z, as quedas e fraturas têm consequências consideráveis para os idosos, pois contribuem para a perda de confiança, quadros álgicos, redução da mobilidade, aumento da dependência, e até mesmo para a mortalidade desses indivíduos. Alguns estudos têm demonstrado o aumento das visitas aos serviços de emergência e internação hospitalar por quedas e fraturas de fêmur associado ao uso de benzodiazepínicos e drogas Z.…”