Patterns of Benzodiazepine Use and Excess Risk of All-Cause Mortality in the Elderly: A Nationwide Cohort Study

Mathieu, Clément; Joly, Pierre; Jacqmin‐Gadda, Hélène; Wanneveich, Mathilde; Bégaud, Bernard; Pariente, Alexandre

doi:10.1007/s40264-020-00992-7

Cited by 19 publications

(17 citation statements)

References 39 publications

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“…In contrast, a Spanish study consisting of older patients with heart failure history ( n = 1017) observed that benzodiazepine users had lower all‐cause mortality (0.70 [0.57–0.87]) but comparable CVD mortality 30 than non‐users. Regardless of these discrepancies in CVD patients, our findings remained broadly consistent with previously published studies among the general elderly that also found higher mortality rates in BZDRs users 9–13 . These and our findings further support current guidelines that argue that BZDRs should be prescribed cautiously and not continuously for more than several weeks, and that its use be especially discouraged among the elderly 31 …”

Section: Discussionsupporting

confidence: 92%

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Use of benzodiazepine and Z‐drugs and mortality in older adults after myocardial infarction

Liu

Soedamah‐Muthu

Meerten

et al. 2022

Int J Geriat Psychiatry

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Section: Discussionsupporting

confidence: 92%

“…However, a critical controversy remains regarding BZDRs use and mortality risk. So far, findings from previous longitudinal studies remain discrepant and yielded no conclusive evidence, ranging from null association 6–8 to a potentially elevated risk of mortality 9–13 in the general elderly population.…”

Section: Introductionmentioning

confidence: 96%

Use of benzodiazepine and Z‐drugs and mortality in older adults after myocardial infarction

Liu

Soedamah‐Muthu

Meerten

et al. 2022

Int J Geriat Psychiatry

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“…We assessed time from the first BZD dispensation to discontinuation of therapy as defined by a gap of at least 90 days between dispensations ( 23 ), as measured using dispensation dates and the number of days supplied. We also described patterns of use ( 10 ). To ensure similar follow-up, we completed these analyses in cohort members who had at least 5 years of follow-up after the index date.…”

Section: Methodsmentioning

confidence: 99%

“…Benzodiazepines may lead to drug dependence and addiction, and are associated with an increased risk of falls, and with cognitive impairment ( 8 , 9 ). In elderly individuals, their use is associated with increased motor vehicle accidents and mortality ( 3 , 10 ). Given the increased propensity for falls and cognitive impairment in the MS population, such adverse effects are a particular concern.…”

Section: Introductionmentioning

confidence: 99%

Use of Benzodiazepines and Z-Drugs in Multiple Sclerosis

et al. 2022

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ObjectiveUse of benzodiazepines and Z-drugs (non-benzodiazepine sedative hypnotics) is controversial due to adverse health outcomes in the general population. However, little is known about their use in people with multiple sclerosis (MS). We estimated the incidence and prevalence of benzodiazepine and Z-drug use (jointly BZD) in the MS population as compared to an age-, sex- and geographically-matched population without MS, and examined the association of mood/anxiety disorders with the use of BZD over a twenty-year period.MethodsUsing administrative data from Manitoba, Canada, we identified 2,985 persons with incident MS and 14,891 persons without MS matched 5:1 on sex, birth year and region. We applied validated case definitions to identify persons with any mood/anxiety disorder. Dispensations of BZD were identified. To assess the association between MS, mood/anxiety disorders and BZD use we constructed generalized linear models adjusting for age, sex, index year, socioeconomic status, urban/rural residence, physical comorbidities, and health care use. We also examined patterns of BZD use.ResultsIn 2016, the crude incidence of benzodiazepine use in the MS cohort was 2.10% (95%CI: 1.43–2.98%), 1.49-fold higher than in the non-MS cohort (1.41%; 95%CI: 1.18–1.67%). The crude incidence of Z-drug use in the MS cohort was 1.77% (95%CI: 1.20–2.51%), 1.78-fold higher than in the non-MS cohort (0.99%; 95%CI: 0.81–1.21%). After adjusting for covariates, among individuals without an active mood/anxiety disorder, the MS cohort had a 39% increased incidence rate of benzodiazepine use and a 72% increased incidence rate of Z-drug use as compared to the non-MS cohort. Among individuals with an active mood/anxiety disorder, the incidence of BZD use did not differ between the MS and non-MS cohorts. A higher proportion of people with MS used BZD for ≥6 months than people without MS.ConclusionUse of BZD is more common in people with MS than in general population controls, and use of these agents is in persons with MS is often chronic.

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“…Benzodiazepine use has been associated with opioid use in IBD as well (14). Benzodiazepines may lead to drug dependence and sedative use disorders and are associated with adverse outcomes related to risk for falls, cognitive impairment, osteoporosis, and even mortality (15)(16)(17)(18). These concerns are underscored in an aging IBD population (19).…”

Section: Introductionmentioning

confidence: 99%

Use of Benzodiazepines and Z-Drugs in Inflammatory Bowel Disease

et al. 2022

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INTRODUCTION:We estimated the incidence and prevalence of benzodiazepine and Z-drug (separately and jointly as BZD) use in the inflammatory bowel disease (IBD) population compared with matched controls without IBD and examined the association of mood/anxiety disorders (M/ADs) with the use of BZD from 1997 to 2017.METHODS:Using administrative data from Manitoba, Canada, we identified 5,741 persons with incident IBD who were matched in a 1:5 ratio to controls on sex, birth year, and region. Validated case definitions were used to identify M/AD. Dispensations of BZD were identified. Multivariable generalized linear models were used to assess the association between IBD, M/AD, and BZD use.RESULTS:In 2016, the incident age/sex-standardized benzodiazepine use rates per 1,000 were 28.06 (95% confidence interval [CI] 26.41–29.81) in the IBD cohort and 16.83 (95% CI 16.28–17.39) in controls (adjusted rate ratio = 1.69 [95% CI 1.56–1.79]). Benzodiazepine incidence rates were higher for women with IBD than men, but the RR between cases and controls were similar for men and women. The incident age/sex-standardized Z-drug use rate per 1,000 was 21.07 (95% CI 19.69–22.41) in the IBD cohort. This was 1.87-fold higher than in controls (95% CI 1.73–2.01). In 2017, approximately 20% of persons with IBD used benzodiazepines and 20% used Z-drugs. There was a subadditive effect of both benzodiazepine and Z-drug uses between IBD and M/AD after adjusting for covariates.DISCUSSION:The use of BZD is more common in people with IBD than in population controls. Strategies to reduce the use of BZDs in persons with IBD and to offer alternative management strategies for M/ADs, sleep disorders, and other symptomatic concerns are needed.

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Patterns of Benzodiazepine Use and Excess Risk of All-Cause Mortality in the Elderly: A Nationwide Cohort Study

Cited by 19 publications

References 39 publications

Use of benzodiazepine and Z‐drugs and mortality in older adults after myocardial infarction

Use of benzodiazepine and Z‐drugs and mortality in older adults after myocardial infarction

Use of Benzodiazepines and Z-Drugs in Multiple Sclerosis

Use of Benzodiazepines and Z-Drugs in Inflammatory Bowel Disease

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