Hogan David B, Maxwell Colleen J, Fung Tak S, Ebly Erika M
Department of Medicine, Health Sciences Centre, Calgary, Canada.
Can J Clin Pharmacol. 2003 Summer;10(2):72-7.
The aim of this study was to evaluate changes in benzodiazepine use over time, and the association between benzodiazepine use and select outcomes.
A five-year longitudinal cohort study in subjects 65 years of age and older.
Select urban communities and institutions across Canada with senior citizens.
Subjects who were first seen in 1990 to 1991, recontacted in 1996, and agreed to undergo a second clinical examination. Mortality rates were based on the initial 2914 subjects enrolled.
Number and type of medications used. Outcomes (mortality, incident institutionalization, change in cognition, depression, function, self-rated health) associated with benzodiazepine use. Logistic regression to predict outcomes and pattern of benzodiazepine use.
Mean number of medications being taken by senior citizens increased to 5.8 from 3.9. The proportion of subjects using benzodiazepines at time 1 and time 2 was similar (26.4% versus 25.2%). Affect, self-rated health, cognition, function and incident institutionalization were significantly associated with benzodiazepine use. Subjects with a depressed mood were more likely to be prescribed a benzodiazepine (37%) than an antidepressant (26.9%).
Benzodiazepines were associated with a number of adverse outcomes. The relative benefits and risks of benzodiazepine use in an older population should be re-examined.
本研究旨在评估苯二氮䓬类药物使用情况随时间的变化，以及苯二氮䓬类药物使用与特定结局之间的关联。
对65岁及以上受试者进行的为期五年的纵向队列研究。
加拿大各地选定的有老年人的城市社区和机构。
1990年至1991年首次就诊、1996年再次联系并同意接受第二次临床检查的受试者。死亡率基于最初纳入的2914名受试者。
使用的药物数量和类型。与苯二氮䓬类药物使用相关的结局（死亡率、入住机构事件、认知变化、抑郁、功能、自评健康状况）。采用逻辑回归预测结局和苯二氮䓬类药物使用模式。
老年人服用药物的平均数量从3.9种增加到5.8种。在第1阶段和第2阶段使用苯二氮䓬类药物的受试者比例相似（26.4%对25.2%）。情感、自评健康状况、认知、功能和入住机构事件与苯二氮䓬类药物使用显著相关。情绪抑郁的受试者比服用抗抑郁药的受试者（26.9%）更有可能被开具苯二氮䓬类药物（37%）。
苯二氮䓬类药物与多种不良结局相关联。应重新审视老年人群使用苯二氮䓬类药物的相对益处和风险。
