CORRELATES AND PREVALENCE OF BENZODIAZEPINE USE IN COMMUNITY-DWELLINGELDERLY

OBJECTIVE: To describe the prevalence of benzodiazepine use, sociodemo graphic and physical health factors associated with use, dosages taken , and directions for use among individuals aged 65 years and older. DE SIGN: Cross-sectional analysis of baseline data from the community-bas ed, prospective observational Cardiovascular Health Study. PATIENTS/PA RTICIPANTS: Medicare eligibility Lists from four U.S. communities were used to recruit a representative sample of 5,201 community-dwelling e lderly, of which 5,181 participants met all study criteria. MEASUREMEN TS AND MAIN RESULTS: Among participants, 511 (9.9%) were taking at lea st one benzodiazepine, primarily anxiolytics (73%). Benzodiazepines we re often prescribed to be taken pro re nata (PRN ''as needed''), and 3 6.5% of prescriptions with instructions to he taken regularly were tak en at a dose lower than prescribed. Reported over-the-counter (OTC) sl eep aid medication use was 39.2% in benzodiazepine users and 3.3% in n onusers. In a multivariate logistic model, the significant independent correlates of benzodiazepine use were being white (odds ratio [OR] 1. 9; 95% confidence interval [CI] 1.0, 3.4), female (OR 1.7; CI 1.4, 2.2 ), and living in Forsyth County, North Carolina, or Washington County, Maryland, compared with living in Sacramento County, California, or A llegheny County, Pennsylvania (OR 2.3; CI 1.4, 2.2); having coronary h eart disease (OR 1.6; CI 1.2, 2.1), health status reported as poor or fair (OR 1.8; CI 1.4, 2.3), self-reported diagnosis of nervous or emot ional disorder (OR 6.7; CI 5.1, 8.7), and reporting use of an OTC slee p aid medication (OR 18.7; CI 14.1, 24.7). CONCLUSIONS: One in 10 part icipants reported taking a benzodiazepine, most frequently an anxiolyt ic, often at a lower dose than prescribed and usually PRN. The high pr evalence of OTC sleep aid medication and benzodiazepine use may place the patient at increased risk of psychomotor impairment. Physicians sh ould assess OTC sleep aid medication use when prescribing benzodiazepi nes.