Prevalence and sociodemographic characteristics associated with benzodiazepines use among community dwelling older adults: the Bambuí Health and Aging Study (BHAS)

Abstract

Introduction Fear or anxious apprehension are emotional responses to danger or threat. For thousands of years humans have used diverse substances to alleviate this negative emotional state. One of the first tranquilizers used, and which continues to be consumed until today, is alcohol; others followed, such as barbiturates, bromides and meprobamates. 1 Since they were released in the market in 1960, the benzodiazepines became the most prescribed drugs and the most used to combat anxiety and insomnia in the whole world.2 This use stemmed from their efficiency, security, and lower potential to cause dependence, their tolerance as well as wide therapeutic applicability. 3 Nonetheless, the use of benzodiazepines has been associated with several adverse effects, such as motor disturbances, falls, daytime sleepiness and cognitive decline. The modifications in metabolism which accompany the ageing process make the elderly an especially vulnerable age group to these undesirable medication effects, 3 which are even worse when long half-life benzodiazepines are used for prolonged periods, especially when not accompanied by an adequate clinical monitoring. 4 The use of benzodiazepines is frequent among the elderly. Although a decrease in prescribing benzodiazepines for the elderly has been observed in some studies, 5,6 population-based studies continue to demonstrate high prevalences in the consumption of these medications in developed countries, and levels ranged from 20.0% in Canada 7 to 31.9% in France.8 With respect to the type of benzodiazepines most used, there is a diversity of results in different countries.8-10 It has been described that female gender is the sociodemographic characteristic most consistently found to be associated with the use of benzodiazepines among the elderly. 5,6,8,9,11 Brazilian epidemiological studies on the use of benzodiazepines among the elderly dealt with selected populations and/or investigated specific associations, such as the occurrence of falls.12-15 Populationbased studies on the consumption of these medications have been accomplished on younger individuals, 16,17 and the benzodiazepine consumption was investigated in a much wider context, which was the use of psychopharmacs. [18][19][20] The population-based studies showed benzodiazepines as the most commonly used psychopharmacs in the adult population, [17][18][19][20] and among these, Diazepam was the most used chemical substance. 16,18,19 In these studies, the consumption of benzodiazepines was higher among women, 16,17 among older subjects and among the wealthy. 17To our knowledge, there are no Brazilian studies on the profile of use of benzodiazepines among community-dwelling older adults. As the use of these medications among the elderly is more frequent and involves greater risks and taking into consideration the rapid aging of the Brazilian population, 21 it is important to investigate this question in greater detail in this country.The present study has the following objectives: 1) to determine the prevalence of be...

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

“…In addition, the different periods of drug use and the sample allocation can partly explain the quantitative differences in BZD use in these studies. Another aspect to be evaluated is the temporal question, that is, information collected before 2000 7,15,16,18,21,25 appear to show higher prevalence of BZD use than more recent studies 17,23 , except for the study of Préville et al than was collected in 2005-2006 and presented a prevalence of 32% 24 . The present investigation trained interviewers and assessed the use of drugs by checking the prescription or packaging of medications.…”

“…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.…”

Patterns of chronic benzodiazepine use in the elderly

“…Brunoni et al presented data from six universities located in different Brazilian regions (São Paulo, Rio de Janeiro, Salvador, Porto Alegre, Belo Horizonte and Vitória), where they detected a BZD use prevalence of 3.9% (in those 35 to 75 years of age), and older people were the most likely to use BZD (OR 3.48) 8 . The prevalence was even higher (21.7%) in an elderly community sample of residents of the city of Bambuí, Minas Gerais, Brazil 21 . Prevalence rates in other countries ranged from 16% in Australia 22 to 31% in Finland 7 and 36% in Canada 6 .…”

Uso de benzodiazepínicos entre idosos: o alívio de "jogar água no fogo", não pensar e dormir

“…Apesar disso, a prevalência do seu consumo nesse segmento etário mantém-se muito elevada -cerca de 30% -, muitas vezes cronicamente, por muitos anos, 5 sendo ainda maior entre idosos mais velhos. 6,7 No Brasil, pessoas idosas são consumidoras frequentes de BZD, como evidenciam estudos epidemiológicos desenvolvidos em diferentes populações, sejam elas residentes em comunidade, com prevalência estimada de 22%, 8 ou usuárias de serviços de saúde, cuja prevalência chega a 30%. 9 Estudos qualitativos demonstram que usuários crônicos de BZD podem desenvolver dependência física e psicológica, conferindo a esses medicamentos atributos que suplantam aqueles decorrentes de sua ação farmacológica.…”