Journal of General Internal Medicine

, Volume 13, Issue 4, pp 243–250 | Cite as

Correlates and prevalence of benzodiazepine use in community-dwelling elderly

  • Patrick P. Gleason
  • Richard Schulz
  • Nicholas L. Smith
  • Jason T. Newsom
  • Patricia D. Kroboth
  • Frank J. Kroboth
  • Bruce M. Psaty
Original Articles


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.

Key words

benzodiazepine sleep aid medication over-the-counter Cardiovascular Health Study elderly anxiolytics 


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Copyright information

© Society of General Internal Medicine 1998

Authors and Affiliations

  • Patrick P. Gleason
    • 1
    • 3
  • Richard Schulz
    • 2
  • Nicholas L. Smith
    • 5
  • Jason T. Newsom
    • 7
  • Patricia D. Kroboth
    • 1
  • Frank J. Kroboth
    • 3
  • Bruce M. Psaty
    • 4
    • 5
    • 6
  1. 1.Received from the Department of Pharmaceutical SciencesSchool of PharmacyUSA
  2. 2.University Center for Social and Urban ResearchUSA
  3. 3.Division of General Internal Medicine, Department of MedicineUniversity of Pittsburgh
  4. 4.Department of MedicineUniversity of WashingtonSeattle
  5. 5.Department of EpidemiologyUniversity of WashingtonSeattle
  6. 6.Department of Health ServicesUniversity of WashingtonSeattle
  7. 7.Regional Research InstitutePortland (Ore.) State UniversityUSA
  8. 8.School of Pharmacy, Dept. of Pharmaceutical SciencesUniversity of PittsburghPittsburgh

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