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Correlates and prevalence of benzodiazepine use in community-dwelling elderly

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Abstract

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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Author information

Authors and Affiliations

  1. Received from the Department of Pharmaceutical Sciences, School of Pharmacy, USA

    Patrick P. Gleason PharmD & Patricia D. Kroboth PhD

  2. University Center for Social and Urban Research, USA

    Richard Schulz PhD

  3. Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pa.

    Patrick P. Gleason PharmD & Frank J. Kroboth MD

  4. Department of Medicine, University of Washington, Seattle

    Bruce M. Psaty MD, PhD

  5. Department of Epidemiology, University of Washington, Seattle

    Nicholas L. Smith MPH & Bruce M. Psaty MD, PhD

  6. Department of Health Services, University of Washington, Seattle

    Bruce M. Psaty MD, PhD

  7. Regional Research Institute, Portland (Ore.) State University, USA

    Jason T. Newsom PhD

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  1. Patrick P. Gleason PharmD
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  2. Richard Schulz PhD
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  7. Bruce M. Psaty MD, PhD
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Additional information

Supported by contracts N01-HC-85079 through N01-HC-85086, from the National Heart, Lung, and Blood Institute, grants AG-09556 and AG13305 from the National Institute on Aging, and grants MH46015 and MH52247 from the National Institutes of Mental Health.

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Gleason, P.P., Schulz, R., Smith, N.L. et al. Correlates and prevalence of benzodiazepine use in community-dwelling elderly. J GEN INTERN MED 13, 243–250 (1998). https://doi.org/10.1046/j.1525-1497.1998.00074.x

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  • DOI: https://doi.org/10.1046/j.1525-1497.1998.00074.x

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