Sustained Benzodiazepine Use in a Community Sample of Older Adults

Abstract

OBJECTIVES-To identify factors associated with sustained benzodiazepine use in older adults DESIGN-12-year cohort studySETTING-Community-based epidemiologic survey. PARTICIPANTS-1,342 individuals aged 65+ yearsMEASUREMENTS-Demographics, medication use, depressive symptoms, sleep complaints, alcohol use, and smoking, assessed at two-year intervals; descriptive analysis to characterize benzodiazepine users and identify factors associated with sustained benzodiazepine use (use at two consecutive waves); longitudinal lag-time analysis to determine characteristics that predicted sustained use. RESULTS-Initially, 5.5 % of men and 9.8 % of women were using benzodiazepines. Users were significantly more likely than non-users to be women, less educated, report more depressive and anxiety symptoms, use more prescription medications, have lower self-rated health, have difficulty maintaining sleep, and less likely to consume alcohol. Approximately 50%, 44%, and 25% of these users aged 65-74. 75-84, and 85+ were sustained users at follow-up. Being female, using two or more non-benzodiazepine prescription medications, and smoking were independently associated with subsequent sustained benzodiazepine use.

Benzodiazepine discontinuation among community-dwelling older people: a population-based cohort study

“…The high rate of discontinuation among the oldest old is encouraging because previous studies have reported that increasing age is associated with long-term benzodiazepine use [1,2]. Unlike in previous studies female sex, mental or neurological disorders and use of other prescription drugs were not associated with long-term use [1][2][3]. A strength of the study was that the Prescription Register included all reimbursed drug purchases for all residents in non-institutional settings.…”

“…Benzodiazepine discontinuation among community-dwelling older people: a population-based cohort study J Simon Bell, PhD, 1,2 Piia Lavikainen, MSc, 1 Mikko Korhonen, MD, 3 Sirpa Hartikainen, MD, Institution of Finland (SII) [7]. Drugs were categorized using the Anatomical Therapeutic Chemical classification system.…”

Prise de benzodiazépines au long cours chez les patients dialysés : une étude descriptive

“…La pré sence d'un syndrome dé pressif associé est é galement identifié e dans d'autres é tudes comme un facteur de risque de l'utilisation chronique de BZD [20,22,25]. D'autres dé terminants identifié s dans la litté rature n'ont pas é té mis en é vidence dans notre é tude : le sexe fé minin [18,21,24] ; la pré sence d'une douleur chronique [25,28] ; la consommation de tabac et d'alcool [29,30].…”

“…Wyne et al, dans une revue de la litté rature, rapportent une pré valence de 8 à 26 % d'utilisation des BZD chez les patients dialysé s [19]. Aucune é tude n'é value la consommation au long cours chez les patients dialysé s. Diffé rents facteurs relatifs aux patients (par exemple l'âge, le sexe, l'anté cé dent de dé pression), aux prescripteurs (la spé cialité du prescripteur, par exemple) ou aux BZD elles-mêmes (par exemple le type de BZD, la dose utilisé e) sont identifié s dans la litté rature comme é tant associé s à une utilisation au long cours [18,[20][21][22][23][24][25][26][27][28][29][30][31][32]. L'ensemble de ces facteurs est identifié en population gé né rale.…”

Utilización de benzodiacepinas según el motivo de ingreso

“…Destaca en el aná lisis multivariante que la toma de benzodiacepinas estaba asociada a una mayor edad, estar institucionalizado y un consumo total de fá rmacos mayor. Los 3 hallazgos son concordantes con resultados previamente descritos 1,2,8 . Al realizar el aná lisis se decidió conservar el nú mero total de fá rmacos, aunque uno de ellos, las benzodiacepinas, fuera el motivo de estudio, debido a que en muchas ocasiones los pacientes podían estar en tratamiento con otros grupos farmacoló gicos (antidepresivos, neurolé pticos) para algunas de las indicaciones de las benzodiacepinas, especialmente en el grupo con el diagnó stico de demencia 9 .…”