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Correlates and prevalence of benzodiazepine use in community-dwelling elderly.

TitleCorrelates and prevalence of benzodiazepine use in community-dwelling elderly.
Publication TypeJournal Article
Year of Publication1998
AuthorsGleason, PP, Schulz, R, Smith, NL, Newsom, JT, Kroboth, PD, Kroboth, FJ, Psaty, BM
JournalJ Gen Intern Med
Volume13
Issue4
Pagination243-50
Date Published1998 Apr
ISSN0884-8734
KeywordsAged, Aged, 80 and over, Benzodiazepines, Cross-Sectional Studies, Drug Utilization, Female, Humans, Male, Practice Patterns, Physicians', Socioeconomic Factors
Abstract<p><b>OBJECTIVE: </b>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.</p><p><b>DESIGN: </b>Cross-sectional analysis of baseline data from the community-based, prospective observational Cardiovascular Health Study.</p><p><b>PATIENTS/PARTICIPANTS: </b>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.</p><p><b>MEASUREMENTS AND MAIN RESULTS: </b>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).</p><p><b>CONCLUSIONS: </b>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.</p>
Alternate JournalJ Gen Intern Med
PubMed ID9565387
PubMed Central IDPMC1496936
Grant ListP30 MH052247 / MH / NIMH NIH HHS / United States
N01-HC-85081 / HC / NHLBI NIH HHS / United States
N01HC85086 / HL / NHLBI NIH HHS / United States
N01-HC-85080 / HC / NHLBI NIH HHS / United States
U01 AG013305 / AG / NIA NIH HHS / United States
N01-HC-85079 / HC / NHLBI NIH HHS / United States
R01 AG009556 / AG / NIA NIH HHS / United States
N01HC85079 / HL / NHLBI NIH HHS / United States