Benzodiazepine use and cognitive function among community-dwelling elderly*

Hanlon, Joseph T.; Horner, Ronnie D.; Schmader, Kenneth E.; Fillenbaum, Gerda G.; Lewis, Ingrid K.; Wall, William E.; Landerman, Lawrence R.; Pieper, Carl F.; Blazer, Dan G.; Cohen, Harvey Jay

doi:10.1016/s0009-9236(98)90059-5

Cited by 176 publications

(150 citation statements)

References 43 publications

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“…[1][2][3][4][5] Drug-disease interaction and chronicity of use are two other common problems associated with benzodiazepine use in this population. 6 As Oude Voshaar et al 7 point out, there is limited evidence suggesting the long-term efficacy in two specific diagnostic groups: panic disorder and social phobia, and the prevalence of these specific disorders among those who are long-term users is relatively low.…”

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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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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“…Ils suggèrent donc que les déficits en mémoire chez les gens âgés soient plus facilement détectables en raison de leur moins bonnes performances mnésiques initiales. Des études plus récentes ont également examiné cet aspect et montrent que les BZD altèrent le fonctionnement mnésique chez les gens âgés (Hanlon et al, 1998 ;Paraherakis et al, 2001). Ces altérations sur le plan de la mémoire semblent varier proportionnellement à la dose (Hanlon et al, 1998).…”

Section: De L'approche Expérimentale à La Clinique Quotidienneunclassified

“…Des études plus récentes ont également examiné cet aspect et montrent que les BZD altèrent le fonctionnement mnésique chez les gens âgés (Hanlon et al, 1998 ;Paraherakis et al, 2001). Ces altérations sur le plan de la mémoire semblent varier proportionnellement à la dose (Hanlon et al, 1998). c) L'absence d'une tolérance complète aux effets des BZD sur la mémoire serait un autre fait appuyant l'idée d'un déficit de la mémoire.…”

Section: De L'approche Expérimentale à La Clinique Quotidienneunclassified

Benzodiazépines : conséquences sur le fonctionnement mnésique des personnes âgées

Bédard

2004

smq

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Des études effectuées chez une population de volontaires sains en administration unique indiquent que les benzodiazépines (BZD) sont connues pour induire des déficits en mémoire. Cette population étudiée ne correspond toutefois pas avec celle qui consomme régulièrement ces substances soit les personnes âgées. Peu d’études ont été faites auprès de cette population cible afin de déterminer l’impact des BZD sur leur mémoire. Par contre, il existe des évidences suggérant aussi qu’il existe des conséquences importantes sur le fonctionnement de la mémoire des personnes âgées qui prennent des BZD. Les données actuelles vont même jusqu’à suggérer que les BZD exacerbent les déficits de mémoire chez les personnes âgées. Cela pourrait même constituer un facteur de risque précipitant le déclin cognitif et augmentant ainsi le risque de développer une démence.Studies conducted with a healthy voluntary population with a unique medication indicate that benzodiazepines (BZD) are known to induce memory deficits. However, this group does not correspond to the population usually using these medication on a regular basis, knowingly the elderly people. Few studies have been conducted with this target population to determine the impact of BZD on their memory. However, some findings suggest that there are important consequences on the functionning of memory of the elderly people taking BZD. The current data go as far as suggesting that BZD exacerbate memory deficits in the elderly. This could even constitute a risk factor that could hasten cognitive decline and thus increase development of dementia.Los estudios efectuados de una dosis única en una población de voluntarios sanos indican que las benzodiacepinas (BDZ) son conocidas por inducir déficit de memoria. Esta población estudiada no corresponde, sin embargo, a la que consume regularmente estas substancias, es decir, las personas de edad avanzada. Se han realizado pocos estudios en esta población objeto a fin de determinar el impacto de las BZD en la memoria. Sin embargo, existen evidencias que sugieren también que existen consecuencias importantes en el funcionamiento de la memoria de las personas de edad avanzada que toman BZD. Los datos actuales llegan a sugerir que las BZD exacerban los déficit de memoria en las personas de edad avanzada. Esto podría incluso constituir un factor de riesgo que precipita la decadencia cognitiva y aumenta de esta manera el riesgo de desarrollar demencia.Estudos efetuados em uma população de voluntários saudáveis em administração única indicam que as benzodiazepinas (BZD) são conhecidas por induzir déficits de memória. Entretanto, esta população estudada não é comparável à que consume regularmente estas substâncias, ou seja, as pessoas idosas. Poucos estudos foram realizados junto a esta população-alvo afim de determinar o impacto das BZD na memória. Por outro lado, existem evidências que também sugerem a existência de conseqüências importantes no funcionamento da memória das pessoas idosas que fazem uso das BZD. Os dados atuais chegam até a sugerir...

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“…Benzodiazepine use in older adults has been associated with numerous deleterious side effects including impairment in activities of daily living, motor vehicle crashes, and problems with gait [1][2][3][4][5]. Expert recommendations explicitly caution against prolonged benzodiazepine use by older individuals and advise that use is justified only if it is intermittent, brief and for purposes of symptom relief [6][7].…”

Section: Introductionmentioning

confidence: 99%

Older primary care patients' willingness to consider discontinuation of chronic benzodiazepines

Cook

Biyanova

Thompson

et al. 2007

General Hospital Psychiatry

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Objective-To examine factors related to older primary care patients' willingness to consider tapering/discontinuation of long-term benzodiazepine use.Method-Forty-six long-term anxiolytic benzodiazepine users, aged 61-95 years, were assessed over the telephone using a semi-structured qualitative interview and standardized self-report questionnaires for anxiety (Beck Anxiety Inventory), sleep quality (Pittsburgh Sleep Quality Index), depression (Center for Epidemiological Studies Depression Scale), psychological dependence on benzodiazepines (Severity of Dependence Scale) and anxiety sensitivity (Anxiety Sensitivity Index).Results-Frequency of daily benzodiazepine intake and anxiety sensitivity significantly contributed to willingness to attempt taper/discontinue benzodiazepines.Conclusion-Many older long-term benzodiazepine users and their physicians perceive tapering of use an arduous, low priority, time intensive task. These findings highlight factors that can help identify a subpopulation of patients who may be easier to engage in the discontinuation process.

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Benzodiazepine use and cognitive function among community-dwelling elderly*

Abstract: The results suggested that current benzodiazepine use, especially in recommended or higher doses, is associated with worse memory among community-dwelling elderly.

Cited by 176 publications

References 43 publications

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

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

Benzodiazépines : conséquences sur le fonctionnement mnésique des personnes âgées

Older primary care patients' willingness to consider discontinuation of chronic benzodiazepines

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