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Prevalence and potential consequences of benzodiazepine use in senior citizens: results from the Canadian Study of Health and Aging.

OBJECTIVES
The aim of this study was to evaluate changes in benzodiazepine use over time, and the association between benzodiazepine use and select outcomes.


DESIGN
A five-year longitudinal cohort study in subjects 65 years of age and older.


SETTING
Select urban communities and institutions across Canada with senior citizens.


PARTICIPANTS
Subjects who were first seen in 1990 to 1991, recontacted in 1996, and agreed to undergo a second clinical examination. Mortality rates were based on the initial 2914 subjects enrolled.


MEASUREMENTS
Number and type of medications used. Outcomes (mortality, incident institutionalization, change in cognition, depression, function, self-rated health) associated with benzodiazepine use. Logistic regression to predict outcomes and pattern of benzodiazepine use.


RESULTS
Mean number of medications being taken by senior citizens increased to 5.8 from 3.9. The proportion of subjects using benzodiazepines at time 1 and time 2 was similar (26.4% versus 25.2%). Affect, self-rated health, cognition, function and incident institutionalization were significantly associated with benzodiazepine use. Subjects with a depressed mood were more likely to be prescribed a benzodiazepine (37%) than an antidepressant (26.9%).


CONCLUSION
Benzodiazepines were associated with a number of adverse outcomes. The relative benefits and risks of benzodiazepine use in an older population should be re-examined.