Elderly Benzodiazepine Users at Increased Risk of Activity Limitations: Influence of Chronicity, Indications, and Duration of Action-The Three-City Cohort.
Identifieur interne : 000159 ( France/Analysis ); précédent : 000158; suivant : 000160Elderly Benzodiazepine Users at Increased Risk of Activity Limitations: Influence of Chronicity, Indications, and Duration of Action-The Three-City Cohort.
Auteurs : Isabelle Carrière [France] ; Thibault Mura [France] ; Karine Pérès [France] ; Joanna Norton [France] ; Isabelle Jaussent [France] ; Arlette Edjolo [France] ; Olivier Rouaud [France] ; Claudine Berr [France] ; Karen Ritchie [Royaume-Uni] ; Marie Laure Ancelin [France]Source :
- American Journal of Geriatric Psychiatry [ 1064-7481 ] ; 2014-11-06.
English descriptors
Abstract
Objective: To examine the cross-sectional and longitudinal associations between benzodiazepine use and daily activity limitations, according to drug indications and duration of action.Design: Prospective cohort study.Setting: Population-based 3-city studyParticipants: 6 600 participants aged 65 years and over included between 1999 and 2001 and followed after 2, 4 and 7 years. Measurements: Benzodiazepine users were separated into hypnotic, short-acting anxiolytic and long-acting anxiolytic users and compared with non users. Three outcomes were examined assessing restrictions in mobility, instrumental activities of daily living (IADL) and social participation. Results: In multivariate simple or mixed logistic models adjusted for socio-demographic variables, impairments and comorbidity and for anxiety, insomnia and depression, hypnotic benzodiazepines were moderately associated with mobility limitation prevalence and IADL limitation incidence. Short-acting and long-acting anxiolytics were associated with IADL limitation prevalence and with mobility limitation prevalence and incidence and long-acting anxiolytics were also associated with IADL limitations incidence. Chronic benzodiazepines users were at a marked risk of developing restrictions for the three outcomes (odds ratio 1.71 (95% confidence interval (CI), 1.23-2.39) for mobility, 1.54 [95%CI, 1.14-2.10] for IADL and 1.74 [95%CI, 1.23-2.47] for participation limitations).Conclusions: Benzodiazepine users are at increased risk of activity limitations regardless of the duration of action or indication. Chronic use of benzodiazepines should be avoided in order to extend disability-free survival.
Url:
Affiliations:
- France, Royaume-Uni
- Languedoc-Roussillon, Occitanie (région administrative)
- Montpellier
- PRES Sud de France, Université Montpellier 1
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<tutelle active="#struct-410122" type="direct"><org type="institution" xml:id="struct-410122" status="VALID"> <idno type="ISNI">0000000120970141</idno>
<orgName>Université de Montpellier</orgName>
<orgName type="acronym">UM</orgName>
<desc> <address> <addrLine>163 rue Auguste Broussonnet - 34090 Montpellier</addrLine>
<country key="FR"></country>
</address>
<ref type="url">http://www.umontpellier.fr/</ref>
</desc>
</org>
</tutelle>
</tutelles>
</hal:affiliation>
<country>France</country>
<placeName><settlement type="city">Montpellier</settlement>
<region type="region" nuts="2">Occitanie (région administrative)</region>
<region type="old region" nuts="2">Languedoc-Roussillon</region>
</placeName>
<orgName type="university">Université Montpellier 1</orgName>
<orgName type="institution" wicri:auto="newGroup">PRES Sud de France</orgName>
</affiliation>
</author>
<author><name sortKey="Ritchie, Karen" sort="Ritchie, Karen" uniqKey="Ritchie K" first="Karen" last="Ritchie">Karen Ritchie</name>
<affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-74520" status="VALID"> <orgName>Department of Epidemiology and Public Health</orgName>
<desc> <address> <addrLine>St Mary's Campus, Norfolk Place, London W2 1PG</addrLine>
<country key="GB"></country>
</address>
</desc>
<listRelation> <relation active="#struct-69530" type="direct"></relation>
</listRelation>
<tutelles><tutelle active="#struct-69530" type="direct"><org type="institution" xml:id="struct-69530" status="VALID"> <orgName>Imperial College London</orgName>
<desc> <address> <addrLine>South Kensington Campus, London SW7 2AZ</addrLine>
<country key="GB"></country>
</address>
<ref type="url">http://www.imperial.ac.uk/</ref>
</desc>
</org>
</tutelle>
</tutelles>
</hal:affiliation>
<country>Royaume-Uni</country>
</affiliation>
</author>
<author><name sortKey="Ancelin, Marie Laure" sort="Ancelin, Marie Laure" uniqKey="Ancelin M" first="Marie Laure" last="Ancelin">Marie Laure Ancelin</name>
<affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-139836" status="VALID"> <idno type="RNSR">201120699F</idno>
<orgName>Neuropsychiatrie : recherche épidémiologique et clinique</orgName>
<desc> <address> <addrLine>Hôpital La Colombière 39 AV Charles Flahault BP 34493 -Pav 42 Calixte Cavalier 34093 CEDEX 5 Montpellier</addrLine>
<country key="FR"></country>
</address>
</desc>
<listRelation> <relation active="#struct-42570" type="direct"></relation>
<relation name="U1061" active="#struct-303623" type="direct"></relation>
<relation active="#struct-410122" type="direct"></relation>
</listRelation>
<tutelles><tutelle active="#struct-42570" type="direct"><org type="institution" xml:id="struct-42570" status="OLD"> <orgName>Université Montpellier 1</orgName>
<orgName type="acronym">UM1</orgName>
<date type="end">2014-12-31</date>
<desc> <address> <addrLine>5, boulevard Henri IV - CS 19044 - 34967 Montpellier cedex</addrLine>
<country key="FR"></country>
</address>
<ref type="url">http://www.univ-montp1.fr/</ref>
</desc>
</org>
</tutelle>
<tutelle name="U1061" active="#struct-303623" type="direct"><org type="institution" xml:id="struct-303623" status="VALID"> <idno type="IdRef">026388278</idno>
<orgName>Institut National de la Santé et de la Recherche Médicale</orgName>
<orgName type="acronym">INSERM</orgName>
<desc> <address> <addrLine>101, rue de Tolbiac, 75013 Paris </addrLine>
<country key="FR"></country>
</address>
<ref type="url">http://www.inserm.fr</ref>
</desc>
</org>
</tutelle>
<tutelle active="#struct-410122" type="direct"><org type="institution" xml:id="struct-410122" status="VALID"> <idno type="ISNI">0000000120970141</idno>
<orgName>Université de Montpellier</orgName>
<orgName type="acronym">UM</orgName>
<desc> <address> <addrLine>163 rue Auguste Broussonnet - 34090 Montpellier</addrLine>
<country key="FR"></country>
</address>
<ref type="url">http://www.umontpellier.fr/</ref>
</desc>
</org>
</tutelle>
</tutelles>
</hal:affiliation>
<country>France</country>
<placeName><settlement type="city">Montpellier</settlement>
<region type="region" nuts="2">Occitanie (région administrative)</region>
<region type="old region" nuts="2">Languedoc-Roussillon</region>
</placeName>
<orgName type="university">Université Montpellier 1</orgName>
<orgName type="institution" wicri:auto="newGroup">PRES Sud de France</orgName>
</affiliation>
</author>
</analytic>
<series><title level="j">American Journal of Geriatric Psychiatry</title>
<idno type="ISSN">1064-7481</idno>
<imprint><date type="datePub">2014-11-06</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass><keywords scheme="mix" xml:lang="en"><term>Activity of daily living</term>
<term>Aging</term>
<term>Benzodiazepines</term>
<term>Longitudinal study</term>
<term>Random-effect model</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"> <p>Objective: To examine the cross-sectional and longitudinal associations between benzodiazepine use and daily activity limitations, according to drug indications and duration of action.Design: Prospective cohort study.Setting: Population-based 3-city studyParticipants: 6 600 participants aged 65 years and over included between 1999 and 2001 and followed after 2, 4 and 7 years. Measurements: Benzodiazepine users were separated into hypnotic, short-acting anxiolytic and long-acting anxiolytic users and compared with non users. Three outcomes were examined assessing restrictions in mobility, instrumental activities of daily living (IADL) and social participation. Results: In multivariate simple or mixed logistic models adjusted for socio-demographic variables, impairments and comorbidity and for anxiety, insomnia and depression, hypnotic benzodiazepines were moderately associated with mobility limitation prevalence and IADL limitation incidence. Short-acting and long-acting anxiolytics were associated with IADL limitation prevalence and with mobility limitation prevalence and incidence and long-acting anxiolytics were also associated with IADL limitations incidence. Chronic benzodiazepines users were at a marked risk of developing restrictions for the three outcomes (odds ratio 1.71 (95% confidence interval (CI), 1.23-2.39) for mobility, 1.54 [95%CI, 1.14-2.10] for IADL and 1.74 [95%CI, 1.23-2.47] for participation limitations).Conclusions: Benzodiazepine users are at increased risk of activity limitations regardless of the duration of action or indication. Chronic use of benzodiazepines should be avoided in order to extend disability-free survival.</p>
</div>
</front>
</TEI>
<affiliations><list><country><li>France</li>
<li>Royaume-Uni</li>
</country>
<region><li>Languedoc-Roussillon</li>
<li>Occitanie (région administrative)</li>
</region>
<settlement><li>Montpellier</li>
</settlement>
<orgName><li>PRES Sud de France</li>
<li>Université Montpellier 1</li>
</orgName>
</list>
<tree><country name="France"><region name="Occitanie (région administrative)"><name sortKey="Carriere, Isabelle" sort="Carriere, Isabelle" uniqKey="Carriere I" first="Isabelle" last="Carrière">Isabelle Carrière</name>
</region>
<name sortKey="Ancelin, Marie Laure" sort="Ancelin, Marie Laure" uniqKey="Ancelin M" first="Marie Laure" last="Ancelin">Marie Laure Ancelin</name>
<name sortKey="Berr, Claudine" sort="Berr, Claudine" uniqKey="Berr C" first="Claudine" last="Berr">Claudine Berr</name>
<name sortKey="Edjolo, Arlette" sort="Edjolo, Arlette" uniqKey="Edjolo A" first="Arlette" last="Edjolo">Arlette Edjolo</name>
<name sortKey="Jaussent, Isabelle" sort="Jaussent, Isabelle" uniqKey="Jaussent I" first="Isabelle" last="Jaussent">Isabelle Jaussent</name>
<name sortKey="Mura, Thibault" sort="Mura, Thibault" uniqKey="Mura T" first="Thibault" last="Mura">Thibault Mura</name>
<name sortKey="Norton, Joanna" sort="Norton, Joanna" uniqKey="Norton J" first="Joanna" last="Norton">Joanna Norton</name>
<name sortKey="Peres, Karine" sort="Peres, Karine" uniqKey="Peres K" first="Karine" last="Pérès">Karine Pérès</name>
<name sortKey="Rouaud, Olivier" sort="Rouaud, Olivier" uniqKey="Rouaud O" first="Olivier" last="Rouaud">Olivier Rouaud</name>
</country>
<country name="Royaume-Uni"><noRegion><name sortKey="Ritchie, Karen" sort="Ritchie, Karen" uniqKey="Ritchie K" first="Karen" last="Ritchie">Karen Ritchie</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>
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