Benzodiazepine use in an elderly community-dwelling population -: Characteristics of users and factors associated with subsequent use

Objectives: The objective of this study was to describe determinants of current and subsequent benzodiazepine use in an elderly population, the Paquid cohort. Methods: The study was conducted on a cohort of 2792 community-dwelling subjects 65 years of age or more living in the Gironde department, southwestern France. Benzodiazepine use and its correlates were studied with data collected at inclusion in the cohort. Longitudinal analysis over a 5-year period of follow-up was done to identify baseline predictors of subsequent use. Results: At baseline, prevalence rate of benzodiazepine use was 31.9%. It was associated with female gender [odds ratio (OR)=2.0; 95% confidence interval (Cl): 1.66, 2.46], previous psychiatric disease (OR=2.87; 95% CI: 2.31, 3.56), concomitant antidepressant use (OR=2.45; 95% CI: 1.59, 3.78), depressive symptomatology (OR=1.70; 95% CI: 1.28, 2.26), multiple drug use (OR=1.82; 95% Cl: 1.50, 2.21), multiple chronic diseases (OR=1.37; 95% CI: 1.12, 1.67) and poor self-perceived health (OR=1.63; 95% CI: 1.33, 2.0). For the 1926 benzodiazepine non-users at inclusion and followed during 5 years, incidence rate of subsequent use was 5.37 per 100 person-years (95% CI: 4.76, 5.98). In multivariate Cox proportional hazards regression analysis, previous psychiatric diseases, poor self-perceived life satisfaction and polymorbidity were significantly associated with subsequent benzodiazepine use. Conclusions: Elderly people are heavy users of benzodiazepines. Independently from mental health status, those in poor health were most at risk of benzodiazepine use.