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QJM. 2019 Aug 19. pii: hcz217. doi: 10.1093/qjmed/hcz217. [Epub ahead of print]

The association between benzodiazepine use and falls, and the impact of sleep quality on this association: Data from the TILDA study.

Author information

1
School of Public Health, Physiotherapy and Sports Science, University College Dublin.
2
Department of Public Health, HSE East, Dublin.
3
The Irish Longitudinal Study on Ageing, Trinity College Dublin.
4
Department of Medical Gerontology, Trinity College Dublin.
5
Mercer's Institute for Successful Ageing, St James's Hospital, Dublin.

Abstract

BACKGROUND:

Benzodiazepines (BZD) are associated with adverse effects, particularly in older adults.

AIM:

This study assess the association between BZD use and falls, and the impact of sleep quality on this association, in community dwelling adults aged over 50.

DESIGN:

Cross-sectional analysis of data from wave 1 of The Irish Longitudinal Study on Ageing.

METHODS:

Participants were classed as BZD users or non-users and asked if they had fallen in the last year, and whether any falls were unexplained. Sleep quality was assessed via self-reported trouble falling asleep, daytime somnolence, and early-rising. Logistic regression assessed for an association between BZD use and falls, and the impact of sleep quality on this association was assessed by categorising based on BZD use and sleep quality variables.

RESULTS:

Of 8,175 individuals, 302 (3.69%) reported taking BZDs. BZD use was associated with falls, controlling for confounders (OR 1.40; 1.08, 1.82; p-value 0.012). There was no significant association between BZDs and unexplained falls, controlling for confounders (OR 1.41; 95% CI 0.95, 2.10; p-value 0.09). Participants who use BZDs and report daytime somnolence (OR 1.93; 95% CI 1.12, 3.31; p-value 0.017), early-rising (OR 1.93; 95% CI 1.20, 3.11; p-value 0.007) or trouble falling asleep (OR 1.83; 95% CI 1.12, 2.97; p-value 0.015), have an increased odds of unexplained falls.

CONCLUSION:

BZD use is associated with falls, with larger effect size in those reporting poor sleep quality in community dwelling older adults. Appropriate prescription of medications such as BZDs is an important public health issue.

PMID:
31424520
DOI:
10.1093/qjmed/hcz217

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