03022nas a2200337 4500008004100000022001400041245008300055210006900138260001300207300001100220490000700231520210300238653000902341653002202350653002002372653002802392653002102420653001102441653001102452653000902463653003502472653002602507100001802533700001402551700001502565700001702580700001802597700001802615700001502633856003602648 1998 eng d a0884-873400aCorrelates and prevalence of benzodiazepine use in community-dwelling elderly.0 aCorrelates and prevalence of benzodiazepine use in communitydwel c1998 Apr a243-500 v133 a

OBJECTIVE: To describe the prevalence of benzodiazepine use, sociodemographic and physical health factors associated with use, dosages taken, and directions for use among individuals aged 65 years and older.

DESIGN: Cross-sectional analysis of baseline data from the community-based, prospective observational Cardiovascular Health Study.

PATIENTS/PARTICIPANTS: Medicare eligibility lists from four U.S. communities were used to recruit a representative sample of 5,201 community-dwelling elderly, of which 5,181 participants met all study criteria.

MEASUREMENTS AND MAIN RESULTS: Among participants, 511 (9.9%) were taking at least one benzodiazepine, primarily anxiolytics (73%). Benzodiazepines were often prescribed to be taken pro re nata (PRN "as needed"), and 36.5% of prescriptions with instructions to be taken regularly were taken at a dose lower than prescribed. Reported over-the-counter (OTC) sleep aid medication use was 39.2% in benzodiazepine users and 3.3% in nonusers. In a multivariate logistic model, the significant independent correlates of benzodiazepine use were being white (odds ratio [OR] 1.9; 95% confidence interval [CI] 1.0, 3.4), female (OR 1.7; CI 1.4, 2.2), and living in Forsyth County, North Carolina, or Washington County, Maryland, compared with living in Sacramento County, California, or Allegheny County, Pennsylvania (OR 2.3; CI 1.4, 2.2); having coronary heart disease (OR 1.6; CI 1.2, 2.1), health status reported as poor or fair (OR 1.8; CI 1.4, 2.3), self-reported diagnosis of nervous or emotional disorder (OR 6.7; CI 5.1, 8.7), and reporting use of an OTC sleep aid medication (OR 18.7; CI 14.1, 24.7).

CONCLUSIONS: One in 10 participants reported taking a benzodiazepine, most frequently an anxiolytic, often at a lower dose than prescribed and usually PRN. The high prevalence of OTC sleep aid medication and benzodiazepine use may place the patient at increased risk of psychomotor impairment. Physicians should assess OTC sleep aid medication use when prescribing benzodiazepines.

10aAged10aAged, 80 and over10aBenzodiazepines10aCross-Sectional Studies10aDrug Utilization10aFemale10aHumans10aMale10aPractice Patterns, Physicians'10aSocioeconomic Factors1 aGleason, P, P1 aSchulz, R1 aSmith, N L1 aNewsom, J, T1 aKroboth, P, D1 aKroboth, F, J1 aPsaty, B M uhttps://chs-nhlbi.org/node/1503