Correlates and prevalence of benzodiazepine use in community-dwelling elderly
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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.
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- Correlates and prevalence of benzodiazepine use in community-dwelling elderly
Journal of General Internal Medicine
Volume 13, Issue 4 , pp 243-250
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- sleep aid medication
- Cardiovascular Health Study
- Industry Sectors
- Author Affiliations
- 1. Received from the Department of Pharmaceutical Sciences, School of Pharmacy, USA
- 2. Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pa.
- 4. University Center for Social and Urban Research, USA
- 5. Department of Epidemiology, University of Washington, Seattle
- 6. Regional Research Institute, Portland (Ore.) State University, USA
- 7. Department of Medicine, University of Washington, Seattle
- 8. Department of Health Services, University of Washington, Seattle