BENZODIAZEPINE EXPOSURE AND FUNCTIONAL STATUS IN OLDER-PEOPLE

OBJECTIVE: To determine the association between benzodiazepine exposur e and functional status in older patients. DESIGN: A nonexperimental, observational study design. SETTING: Kaiser Permanente, Northwest Divi sion, a health maintenance organization (HMO) providing prepaid, compr ehensive inpatient and outpatient care for more than 410,000 persons. PATIENTS: Patients were the 4192 Social HMO Project members 65 years o f age and older, enrolled for 1 full year, who returned their annual h ealth status survey during 1990. MEASUREMENTS: Functional status was m easured using self-reported activities of daily living and instrumenta l activities of daily living. Predictor variables were self-reported m edical conditions and benzodiazepine exposure during the previous 12 m onths. RESULTS: Age, gender, and living status were associated with fu nctional status. Severe memory loss, stroke, Parkinson's disease, circ ulation problems, lung problems, hip fracture, urinary problems, arthr itis, heart trouble, diabetes, stomach/bowel problems, and cancer were associated independently with functional status. Persons exposed to a benzodiazepine scored lower on the functional status measure. Benzodi azepine exposure added significantly to the prediction of functional s tatus after controlling for patients' sociodemographic characteristics and medical conditions. CONCLUSIONS: Age and medical conditions were the most significant predictors of functional status. Benzodiazepine e xposure was associated with functional status to the same extent as se veral chronic medical conditions. When prescribing benzodiazepines for older people, caution should be taken to minimize the possibility of iatrogenic-functional limitations.