Correlates and prevalence of benzodiazepine use in community-dwelling elderly

Gleason, Patrick P.; Schulz, Richard; Smith, Nicholas L.; Newsom, Jason T.; Kroboth, Patricia D.; Kroboth, Frank J.; Psaty, Bruce M.

doi:10.1046/j.1525-1497.1998.00074.x

Cited by 98 publications

(128 citation statements)

References 55 publications

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“…5 Potential Confounding Variables-Several demographic, health status, and health behavior factors were identified from the literature that may be confounders of the association between benzodiazepine use and disability. 1,2,19,20 Demographic variables included age, sex, education (completed high school, did not complete high school), and annual income (<$15,000, ≥$15,000). Health behavior variables included smoking status at baseline (current, past, never) and alcohol use (nondrinker, 1 drink/day, >1 drink/day).…”

Section: Data Collectionmentioning

confidence: 99%

“…1,2 Use of benzodiazepines has been associated with several negative health consequences, including falls, 3 hip fractures, 4,5 depressed mood, 6 and impaired cognition. 7 Long-term use of benzodiazepines is more common in older than in younger individuals, 8 despite recommendations to avoid prolonged use in older people.…”

Section: Introductionmentioning

confidence: 99%

“…Differences in health status are likely to exist between anxiolytic and hypnotic users that we were unable to account for in this study that may explain the significant association. 1 We classified medications according to the FDAapproved indication, acknowledging that medications are not always prescribed according to FDA-approved indications.Second, the inclusion of health-related variables in the multivariate models reduced the strength of the association between benzodiazepine use and the disability outcomes. It is likely that we have not eliminated confounding by related disease and symptom states.…”

mentioning

confidence: 99%

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Is the Use of Benzodiazepines Associated with Incident Disability?

Gray¹,

LaCroix

Blough³

et al. 2002

J American Geriatrics Society

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OBJECTIVES-This study examined the association between benzodiazepine use and incident disability with an emphasis on elucidating whether the underlying health conditions that result in benzodiazepine use (confounding factors) or intrinsic adverse effects of benzodiazepine use were responsible for functional decline. DESIGN-Cohort study with follow-up of 4 to 5 years. SETTING-A health maintenance organization (HMO) in western Washington.PARTICIPANTS-Individuals aged 65 and older from a random sample of HMO enrollees who participated in a health promotion intervention trial (n = 1,519).MEASUREMENTS-Benzodiazepine use was ascertained from computerized pharmacy records. Self-reported functional status was assessed using a six-item physical function scale ranging from vigorous activity to self-care activities of daily living (ADLs). Two outcomes were examined: decline in overall physical function and limitations in self-care ADLs. Multivariate models were examined that included demographic characteristics, health status, and health behaviors that were likely to be confounders. Several analyses were conducted to examine whether benzodiazepine use or confounding factors were responsible for functional decline.Address correspondence to Shelly L. Gray, PharmD, MS, University of Washington, School of Pharmacy, Health Sciences Center H-361D, Box 357630, Seattle, WA 98195. slgray@u.washington.edu. HHS Public AccessAuthor manuscript J Am Geriatr Soc. Author manuscript; available in PMC 2016 March 03. Published in final edited form as:J Am Geriatr Soc. 2002 June ; 50(6): 1012-1018. Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript RESULTS-Benzodiazepine use was significantly associated with incident loss of physical function (hazard ratio (HR) = 1.51, 95% confidence interval (CI) = 1.02-2.24) in the fully adjusted model. Although use of benzodiazepines was associated with limitations in ADLs, it was not significant when adjusting for other factors (HR = 1.71, 95% CI = 0.87-3.34). Several of our findings suggest that the health conditions leading to benzodiazepine use may partly or fully explain these associations: (1) use of anxiolytic benzodiazepines (HR = 1.95, 95% CI = 1.24-3.07), but not hypnotic agents (HR = 1.21, 95% CI = 0.73-2.00), was associated with functional decline; (2) adjustment for health status variables minimized these associations; and (3) there was little evidence of dose response.CONCLUSIONS-A modestly increased risk for decline in physical function was associated with benzodiazepine use, especially of anxiolytic agents. The health conditions that result in benzodiazepine use may be more important in the pathogenesis of disability than benzodiazepine use itself. Although there are many reasons for avoiding benzodiazepines in older adults, it is still unclear whether use contributes independently to functional decline. One problem encountered when attempting to examine the effect of benzodiazepine use on functional decline is determining whether it is the drug itself or the med...

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Section: Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Is the Use of Benzodiazepines Associated with Incident Disability?

Gray¹,

LaCroix

Blough³

et al. 2002

J American Geriatrics Society

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“…Few studies have assessed the prevalence of benzodiazepines use in elderly. In Brazil, the prevalence rates range from 6.1 to 21.7% and up to 32% in international studies 7,[15][16][17][18][19][20][21][22][23] . In this context, the aim of this study was to investigate whether the prevalence of use of BZD in the Midwestern region differs from other regions.…”

Section: Introductionmentioning

confidence: 99%

Benzodiazepine use and associated factors in elderly in the city of Dourados, MS, Brazil

Cunha

Souza

Cattanio

et al. 2015

J. bras. psiquiatr.

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Objective: The use of benzodiazepines (BZD) and associated factors in the elderly of Dourados, MS, Brazil was investigated. Methods: This is a cross-sectional population-based study using a multistage sampling design. Participants were 1,022 individuals aged ≥ 60 years. Measurements: socioeconomic status, schooling, demographic aspects, marital status, physical activity, hospitalizations, self-rated health, use of alcohol beverages and smoking were assessed by standard questionnaire. The drugs used were obtained by checking the prescription or package and classified according to the Anatomical Therapeutic Chemical Index. Chi-square test, Chi-square for linear tendency, Fisher's exact test and Poisson regression were used to assess association between variables. Results: The prevalence of use of BZD was 6.5% (CI95%: 5.1-8.2%). The oldest group (PR: 1.60 for 70-79 years and PR: 1.79 for ≥ 80 years), non-use of alcohol (PR: 4.14) and use of antidepressants (PR: 8.73) were the statistically associated characteristics. Conclusions: The prevalence of use of BZD in the study population was low, similar to findings of more recent Brazilian studies and lower than those obtained in international studies. The prevalence of use of BZD increased with aging and use of antidepressants. REsUMOObjetivo: Foi investigado o uso de benzodiazepínicos (BZD) e fatores associados em idosos no município de Dourados, MS. Métodos: Delineamento transversal, de base populacional com amostra de conglomerados estratificada e em múltiplos estágios. Os participantes totalizaram 1.022 indivíduos com idade > 60 anos. Foi utilizado questionário padronizado com as variáveis nível econômico, escolaridade, demográficas, situação conjugal, exercícios físicos, internações hospitalares, autopercepção de saúde, uso de bebida alcoólica e fumo. Os medicamentos utilizados foram obtidos por meio da verificação da receita médica ou embalagem e classificados segundo o Anatomical Therapeutic Chemical Index. Para avaliar a associação entre as variáveis foram utilizados os testes do qui-quadrado, de tendência linear, exato de Fisher e regressão de Poisson. Resultados: A prevalência do uso de BZD foi de 6,5% (IC95%: 5,1-8,2%). A maior idade (RP: 1,60 para 70-79 anos e RP: 1,79 para > 80

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“…12 In a study of older adults from 4 U.S. communities, 1 in 10 reported taking a benzodiazepine, most frequently an anxiolytic. 13 It is important to understand factors contributing to long-term benzodiazepine use in this population, a pattern that persists despite availability of safer alternatives for the complaints for which these medications are typically prescribed. Identifying these factors could assist in the development of strategies to reduce chronic use in older adults.…”

Section: Introductionmentioning

confidence: 99%

Older Patient Perspectives on Long-Term Anxiolytic Benzodiazepine Use and Discontinuation: A Qualitative Study

et al. 2007

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OBJECTIVE:The objective of the study is to understand patient factors contributing to the chronicity of benzodiazepine use by older adults as a first step in the development of acceptable intervention strategies for taper/discontinuation or prevention of chronic use. DESIGN:The design of the study consists of qualitative semi-structured patient interviews. SETTING AND PARTICIPANTS:The participants were 50 anxiolytic benzodiazepine users, 61-95 years of age, recruited through referrals from primary care physicians who practiced in the general Philadelphia, Pennsylvania area.RESULTS: Many older chronic users have come to rely and psychologically depend on benzodiazepines for their unique soothing properties, attributing to these medications characteristics that extend beyond an ordinary medication, i.e., affording control over daily stress, bringing tranquility, and even prolonging life. Most of the patients denied or minimized side effects and expressed resistance to taper or discontinuation, ranging from subtle reluctance to outright refusal and fear of being left suffering without these medications. CONCLUSIONS:The reluctance of older chronic benzodiazepine users to taper or discontinue use highlights the importance of prevention and early intervention strategies to avoid the development of chronic use. Suggestions for curbing chronic use are presented.

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Correlates and prevalence of benzodiazepine use in community-dwelling elderly

Cited by 98 publications

References 55 publications

Is the Use of Benzodiazepines Associated with Incident Disability?

Is the Use of Benzodiazepines Associated with Incident Disability?

Benzodiazepine use and associated factors in elderly in the city of Dourados, MS, Brazil

Older Patient Perspectives on Long-Term Anxiolytic Benzodiazepine Use and Discontinuation: A Qualitative Study

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