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Benzodiazepines Linked to Declines in Elderly: Presented at AGS

By Roberta Friedman, PhD

BALTIMORE, MD -- May 20, 2003 -- Older women who use benzodiazepines for prolonged periods or at higher doses can increase their risk of declines in physical abilities, according to findings reported here May 16^th at the Annual Meeting of the American Geriatrics Society.

Investigator Shelly Gray, PharmD, of the pharmacy department at University of Washington, in Seattle, presented the 4-year, prospective, cohort study, which included 885 women older than 70 years (mean 77.7 years).

"I think there is a trend not to use" benzodiazepines in the elderly, she said, but acknowledged that many elderly are addicted to them.

Investigators used the database of the Iowa Established Populations for Epidemiologic Studies of the Elderly. All women were Caucasian and 41% had less than 12 years of education.

The women were all given a battery of performance tests in 1988 and 1992 to assess standing balance, walking speed, and time to rise from a chair five times. These measures were pooled into a single score of 0 to 12, with 12 representing best functioning. Average baseline score was 7.8, with median loss of a point on the score in 4 years.

Ninety women (10.2%) reported using benzodiazepines at baseline, including temazepam, lorazepam, and alprazolam as well as diazepam. They were found to be 2.64 times more likely to have their score decreased significantly over the 4 years of follow up.

Results revealed greater declines for the 90 women who reported daily use of the drug after adjusting for baseline physical performance, demographic characteristics, health status, and health behaviours (P<.001). The decline was related to use of higher doses than those recommended for use in the elderly (P<.001), women whose dose was within those in the range recommended by the guidelines did not have a higher risk (P<.246), Dr. Gray said.

Current use of the drugs, compared to not currently taking them, was associated with a greater decline in physical performance. This difference in risk for physical decline was statistically significant (p<0.001). Women who used the drugs for more than 3 years had greater declines in physical performance (P<.001).

Dosing of the class of drugs in the elderly depends on the drug, said Dr. Gray, with diazepam requiring a lower starting dose, and temazepam not needing a lower dose for older patients. The study defined recommended dose as the suggested starting dose for the elderly.


[Study title: Benzodiazepine Use and Physical Performance in Community Dwelling Older Women. Abstract 452]

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