Benzodiazepine Use as a Cause of Cognitive Impairment in Elderly Hospital Inpatients

Foy, Aidan; O’Connell, Dianne; Henry, David; Kelly, Jill; Cocking, Sue; Halliday, Judith

doi:10.1093/gerona/50a.2.m99

Cited by 135 publications

(86 citation statements)

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“…The use of benzodiazepines in this age group is of particular concern, because they may be a risk factor for falls and for cognitive impairment in the elderly. 23,24 The reduction of prescriptions requires the substitution of other treatments for sleep problems and for anxiety, many of which are non-pharmacological. It must be acknowledged that access to these treatments requires greater expertise from GPs or referrals to specialists, which may not be readily available.…”

Section: Discussionmentioning

confidence: 99%

Long-term benzodiazepine use by elderly people living in the community

Jorm

Grayson

Creasey

et al. 2000

Australian and New Zealand Journal of Public Health

109

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Objective : To investigate the prevalence of long‐term benzodiazepine use in an elderly community sample, and factors associated with such use. Method : Data came from the Sydney Older Persons Study, a longitudinal study of people aged 75 or over. There were 337 subjects who were interviewed in 1991–93, and subsequently followed up after three and 4.5 years. At the first interview, subjects were assessed for socio‐demographic characteristics, physical and mental health, and use of health services. At the first and subsequent interviews, subjects were asked about use of medications, including benzodiazepines. Results : There were 16.6% who were using benzodiazepines at the time of all three interviews, while a further 19.6% were using them at one or two interviews. In a multivariate ordered logit regression model, long‐term benzodiazepine use was associated with treatment for nervous conditions, restless sleep, being female, being divorced and greater contact with medical services. Conclusions : The prevalence of benzodiazepine use in the elderly is high and much of this use is long term. The high prevalence of benzodiazepine use stands in contrast to the findings from national surveys that the elderly living in the community tend to have better mental health than younger age groups. Implications : Efforts are needed to reduce the number of elderly people becoming long‐term users. The use of benzodiazepines in this age group is of particular concern, because they may be a risk factor for falls and for cognitive impairment in the elderly.

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Section: Discussionmentioning

confidence: 99%

Long-term benzodiazepine use by elderly people living in the community

Jorm

Grayson

Creasey

et al. 2000

Australian and New Zealand Journal of Public Health

109

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“…The sodium abnormality combined OR was 2.2 (95% CI 1.3, 4.0). Foy et al 35 and Koponen et al 41 provided isolated results of association for hypoxia and abnormal cerebrospinal fluid, respectively. Other electrolyte derangements and abnormal glucose or leukocytes demonstrated a weak association, whereas abnormal hemoglobin, albumin, 27 calcium, 13 liver function tests, 13 or presence of leukocytes in the urine 27 did not.…”

Section: Risk Factor Analysismentioning

confidence: 99%

Delirium risk factors in elderly hospitalized patients

et al. 1998

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OBJECTIVE: Delirium is frequent in elderly hospitalized patients. Many studies have examined its risk factors, but results have been quite variable. Thus, the goal of this study is to identify through systematic literature review the risk factors associated with the development of delirium in hospitalized geriatric patients. MEASUREMENTS AND MAIN RESULTS:First, MEDLINE / CURRENT CONTENTS databases were screened for relevant articles published from 1966 to December 1995, and from bibliographies of identified articles additional reports were selected. Second, the reports were screened by two different investigators and retained only if meeting the five following criteria: (1) original research in French or English; (2) prospective study; (3) patients over age 50; (4) minimum of one risk factor examined; (5) acceptable definition of delirium. Third, the methodology of each study was graded according to specific criteria for risk factor studies. Fourth, risk factors were identified and tabulated, unadjusted odds ratios (ORs) were computed, and where appropriate a combined OR with the Mantel-Haenszel estimator was calculated. Twenty-seven articles were retained meeting all of the above criteria. Among these studies, 11 were done on medical patients, 9 on surgical patients, 2 on medical and surgical patients, and 5 on psychiatric patients. In total 1,365 subjects with delirium were studied. Sixty-one different risk factors were examined, the five most common being dementia, medication, medical illness, age, and male gender. Mantel-Haenszel estimator was calculated for 10 risk factors, the most strongly associated being dementia (OR 5.2; 95% confidence interval [CI] 4.2, 6.3), medical illness (OR 3.8; 95% CI 2.2, 6.4), alcohol abuse (OR 3.3; 95% CI 1.9, 5.5), and depression (OR 1.9; 95% CI 1.3, 2.6). Methodologic weaknesses were present in many studies.

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“…La littérature révèle que l'usage prolongé de BZD occasionne un affaiblissement des fonctions cognitives (Egan et al, 2000 ;Foy et al, 1995). En outre, on observe des manifestations d'amnésie antérograde (Julien, 1999), des épisodes de confusions mentales qui peuvent ressembler à une démence (Larson et al, 1987) et l'aggravation de la démence chez les individus qui en démontrent des signes précurseurs (Holroyd et Duryee, 1997).…”

Section: Effets Au Niveau Cognitifunclassified

“…D'ailleurs, la préexistence d'une détérioration mentale non diagnostiquée peut se révéler à la suite de la consommation de BZD (Julien, 1999). Le risque de développer un delirium augmente lorsque certains facteurs de risque, par exemple, l'âge avancé, la présence d'un cancer ou d'un diagnostic au niveau du système nerveux central, sont combinés à l'usage de BZD (une dose quotidienne équivalente à plus de 5 mg de diazépam) (Foy et al, 1995).…”

Section: Effets Au Niveau Cognitifunclassified

Usage des benzodiazépines chez les personnes âgées : état des connaissances

Rouleau

Proulx

O’Connor

et al. 2004

smq

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Cet article passe en revue la littérature concernant la dépendance aux benzodiazépines (BZD) chez la population des personnes âgées de 65 ans et plus. Alors que les conséquences négatives reliées à l’utilisation prolongée des BZD sont bien connues, le phénomène de la dépendance à ces substances chez cette population l’est beaucoup moins. Il n’existe toujours pas de consensus autour de la définition du problème. L’usage continu des BZD peut être davantage problématique chez les personnes âgées pour qui la tolérance aux agents chimiques diminue avec l’âge. Les facteurs de risque impliqués dans l’usage chronique sont une combinaison interactive entre les caractéristiques des aînés et celles des médecins prescripteurs. Des pistes de recherche étayées sur un changement paradigmatique sont lancées afin de bonifier la recherche dans ce domaine.This article reviews the literature concerning addiction to benzodiazepine (BZD) in the elderly population of 65 and over. While the negative consequences related to a prolonged use of BZD are well known, much less is known on the phenomenon of dependency to these substances in this population. There is still no consensus on the definition of the problem. The continuous use of BZD may be more problematic in the elderly for whom tolerance to chemical agents diminishes with age. The risk factors involved in the chronic use are an interactive combination between the charateristics of the elderly as well as the physicians who prescribe such medication. Paths of research to support a paradigmatic change are presented in order to improve the research in this field.Este artículo examina sucesivamente la literatura concerniente a la dependencia de benzodiacepinas (BDZ) en la población de 65 años y más. Mientras que las consecuencias negativas relacionadas con el uso prolongado de las BZD son muy conociadas, el fenómeno de dependencia de estas substancias en esta población es mucho menor. No existe aún un concenso sobre la definición del problema. El uso continuo de BZD puede ser más problemático en las personas de edad avanzada, cuya tolerancia a los agentes químicos disminuye con la edad. Los factores de riesgo implicados en el uso crónico son una combinación interactiva entre las características de los ancianos y las de los médicos que las prescriben. Se lanzan pistas de investigación apoyadas en un cambio paradigmático a fin de mejorar la investigación en este campo.Este artigo passa em revista a literatura sobre a dependência das benzodiazepinas (BZD) na população das pessoas com 65 anos ou mais. Ao passo que as conseqüências negativas relacionadas com a utilização prolongada das BZD são bem conhecidas, o fenômeno da dependência a estas substâncias na população idosa é muito menos conhecida. Ainda não existe consenso a respeito da definição do problema. O uso contínuo das BZD pode ser muito mais problemático em pessoas idosas, onde a tolerância a agentes químicos diminui com a idade. Os fatores de risco implicados no uso crônico são uma mistura interativa entre as características dos ...

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Benzodiazepine Use as a Cause of Cognitive Impairment in Elderly Hospital Inpatients

Cited by 135 publications

References 0 publications

Long-term benzodiazepine use by elderly people living in the community

Long-term benzodiazepine use by elderly people living in the community

Delirium risk factors in elderly hospitalized patients

Usage des benzodiazépines chez les personnes âgées : état des connaissances

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