Benzodiazepine Use Among Older Adults

Gupta, Aarti; Bhattacharya, Gargi; Balaram, Kripa; Tampi, Deena J.; Tampi, Rajesh R.

doi:10.2217/nmt-2020-0056

Cited by 10 publications

(13 citation statements)

References 15 publications

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“…In a research study done by Marron et al 2020, benzodiazepine drugs were associated with falls in geriatric patients and the incidence of falls increased in patients who also experienced worsening sleep quality. The use of benzodiazepines for geriatric patients is to treat anxiety disorders, sleeping disorders and muscle relaxants (Gupta et al 2021). Benzodiazepines work by binding to benzodiazepine receptors located on GABA-A receptors in the central nervous system.…”

Section: Discussionmentioning

confidence: 99%

“…One of the side effects that can occur with the use of benzodiazepines is falling because benzodiazepines cause sedation, unstable gait and psychomotor incoordination. Benzodiazepines with long-term use also have the potential to cause irreversible cognitive impairment in the elderly (Gupta et al 2021). In a study conducted by long-acting benzodiazepines were more at risk of falling than short-acting benzodiazepines.…”

Section: Discussionmentioning

confidence: 99%

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Analysis of fall risk increasing drugs on Morse Fall Scale in geriatric patients (a study at geriatric outpatient clinic Airlangga University Teaching Hospital)

Yulistiani¹,

Utomo²,

Nugroho³

et al. 2023

PHAR

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Falls are the geriatric syndromes that become one of the main causes of injury, even death in the elderly. It is known that one of the risk factors for falling is the use of certain drugs that have the effect of orthostatic hypotension, sedation, balance disruptions, and other side effects. This study aims to examine the risk of falling based on Morse scale of geriatric patient that use fall-risk drug. Retrospective data were taken from e-prescriptions for geriatric patients and interviews with the patients to determine the risk of falling based on the Morse scale. The results showed that 115 patients who used the fall-risk drug had an average risk of falling from mild to moderate. The high fall-risk drug used by most patients was gabapentin (43%), the moderate fall-risk drug was candesartan (60%), and the low fall-risk drug was furosemide (9%). Patients with the total of 71% received a combination of two to four fall-risk drugs. Total MFRS of ≥6 was 53% patients, meaning that the patients’ using of drugs needed to be evaluated. From the results of statistical analysis, it was found that the number of fall risk drugs received by patients was not associated to the risk of falling in geriatric patients, while increasing the dose of high fall-risk drugs such as gabapentin, increased the fall risk level in geriatric patients. From the result of this study, it is known that fall-risk drugs are widely used by patients, hence it is necessary to increase the awareness of falling in geriatric patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Analysis of fall risk increasing drugs on Morse Fall Scale in geriatric patients (a study at geriatric outpatient clinic Airlangga University Teaching Hospital)

Yulistiani¹,

Utomo²,

Nugroho³

et al. 2023

PHAR

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“…Include the intake of anticholinergic drugs, including antihistamines, and benzodiazepines as potential confounders of study outcomes. These drugs are associated with adverse cognitive effects in older adults [ 110 , 111 ] and may lead to spurious results if they are not analyzed as part of the study. Only one RCT analyzed [ 34 ] included anticholinergic drugs as a potential confounder.…”

Section: Beyond Study Limitations To Practical Recommendationsmentioning

confidence: 99%

A Critical Review of the Study of Neuroprotective Diets to Reduce Cognitive Decline

Duplantier

Gardner

2021

Nutrients

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Alzheimer’s disease (AD) and other dementias are now the seventh leading cause of death in the world and are projected to affect 115.4 million people by 2050. Delaying the onset of AD by just five years is estimated to reduce the cost and prevalence of the disease by half. There is no cure for AD nor any drug therapies to halt its progression once the disease begins. Lifestyle choices including diet are being seen as a viable complementary therapy to reduce cognitive decline, the hallmark of AD. Mediterranean, DASH (Dietary Approaches to Stop Hypertension), and MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diets have biological mechanisms supporting their potential neuroprotective benefits, but the findings of study outcomes about these benefits have been inconsistent. This paper analyzed five Randomized Clinical Trials (RCTs) (from 2000 to 2021) and 27 observational studies (from 2010 to 2021) focused on the link between cognitive health and the Mediterranean/DASH/MIND diets to identify gaps and challenges that could lead to inconsistent results. These include a lack of accuracy in assessing food intake, multiple dietary pattern scoring systems, a shifting metric among studies focused on the Mediterranean diet, a lack of standards in the tools used to assess cognitive decline, and studies that were underpowered or had follow-up periods too short to detect cognitive change. Insights from these gaps and challenges are summarized in recommendations for future RCTs, including both pragmatic and explanatory RCTs.

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“…However, the most common strategy to treat insomnia remains the use of hypnotic medications, with BZDs being one of the most frequent classes of drugs in use 4 . BZDs are more commonly used by older than younger people, and the rate of use is increasing 5 …”

Section: Introductionmentioning

confidence: 99%

“…4 BZDs are more commonly used by older than younger people, and the rate of use is increasing. 5 On one hand BZDs prove to be quite effective, with a short onset of action and a good tolerability profile. 6 However, there have been increasing concerns regarding their use, as they can be addictive in the long-term and have serious adverse effects such as craving, withdrawal symptoms upon discontinuation, sedation, drowsiness and increased falls, cognitive decline, and delirium.…”

Section: Introductionmentioning

confidence: 99%

Discontinuation of benzodiazepines and Z‐drugs in hospitalised population at the age of 60 and above. An open‐label randomized controlled trial

Kosto,

Lev,

Reiss

et al. 2023

Int J Geriat Psychiatry

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BackgroundTreating insomnia with hypnotic drugs in elderly patients has many adverse effects. This study aims to assess the effect of two discontinuation methods of hypnotic drugs during acute hospitalization.MethodsWe conducted an open‐label randomized controlled trial that included participants aged 60 and above taking benzodiazepines or Z‐Drugs for at least 3 months as a treatment for insomnia and were admitted to the hospital. In the prospective arm, patients were randomly assigned into two intervention groups. In the Minimal Intervention (MI) group, patients received an explanation of the dangers of long‐term treatment and a recommendation to stop the treatment. In the Tapering Down Intervention (TDI) group, in addition to the explanation, patients received a tapering down table. In the retrospective arm (control group), we examined the use of hypnotic drugs among hospitalized patients 3 months after hospitalization, similar to the patients in the prospective arm.Results46 patients were enrolled in the MI group, 55 patients in the TDI group, and 114 patients in the control group. The mean age in the three groups was 75.0 ± 8.2, 75.9 ± 9.0, and 75.0 ± 7.9 years respectively (p = 0.85). After 3 months, seven (15.2%) of the patients in the MI group, 15 (27.3%) in the TD group, and 2 (1.8%) in the control group (p = 0.00003) were weaned from the hypnotic drugs treatment, without a significant difference between the intervention groups (p = 0.221).ConclusionsA short intervention during hospitalization results in a significant decrease in hypnotic drug use.

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Benzodiazepine Use Among Older Adults

Cited by 10 publications

References 15 publications

Analysis of fall risk increasing drugs on Morse Fall Scale in geriatric patients (a study at geriatric outpatient clinic Airlangga University Teaching Hospital)

Analysis of fall risk increasing drugs on Morse Fall Scale in geriatric patients (a study at geriatric outpatient clinic Airlangga University Teaching Hospital)

A Critical Review of the Study of Neuroprotective Diets to Reduce Cognitive Decline

Discontinuation of benzodiazepines and Z‐drugs in hospitalised population at the age of 60 and above. An open‐label randomized controlled trial

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Benzodiazepine Use Among Older Adults

Cited by 10 publications

References 15 publications

﻿Analysis of fall risk increasing drugs on Morse Fall Scale in geriatric patients (a study at geriatric outpatient clinic Airlangga University Teaching Hospital)

﻿Analysis of fall risk increasing drugs on Morse Fall Scale in geriatric patients (a study at geriatric outpatient clinic Airlangga University Teaching Hospital)

A Critical Review of the Study of Neuroprotective Diets to Reduce Cognitive Decline

Discontinuation of benzodiazepines and Z‐drugs in hospitalised population at the age of 60 and above. An open‐label randomized controlled trial

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Analysis of fall risk increasing drugs on Morse Fall Scale in geriatric patients (a study at geriatric outpatient clinic Airlangga University Teaching Hospital)

Analysis of fall risk increasing drugs on Morse Fall Scale in geriatric patients (a study at geriatric outpatient clinic Airlangga University Teaching Hospital)