Health Center, CNAMTS, Lyon, University of Lyon, France.
J Nutr Health Aging. 2011 Jan;15(1):72-7. doi: 10.1007/s12603-011-0015-7.
While the association between benzodiazepines (BZD) and single fall is long-known, the association between BZD and recurrent falls has been few studied.
The aims of this study were 1) to examine whether BZD were associated with recurrent falls while taking into account the effect of potential confounders, and 2) to determine whether there was an interaction in terms of risk of falls between BZD and balance impairment in a community-dwelling population-based adults aged 65 and older.
Cross-sectional.
Three health centers in North-East of France.
7643 community-dwelling volunteers aged 65 and older.
The use of BZD, the Mini Mental State Examination (MMSE) score, the Clock Drawing Test (CDT), the One Leg Balance (OLB) test, the Five Times Sit-To-Stand test (FTSS), and a history of falls were recorded. Subjects were separated into 4 groups based on the number of falls: 0, 1, 2 and ≥ 3 falls.
Among the 1456 (19.2%) fallers, 994 (13.0%) were single fallers and 462 (6.1%) were recurrent fallers (i.e., > 2 falls). The number of falls increased significantly with age (Incident Rate Ratio (IRR)=1.04, P < 0.001), female gender (IRR=2.24, P < 0.001), the use of benzodiazepine (IRR=1.65 P < 0.001) and especially while subjects used bromazepam (IRR=1.44, P=0.006), clobazam (IRR=3.01, P=0.014) and prazepam (IRR=2.29, P < 0.001). A low MMSE score (IRR=0.96, P < 0.001), an impaired CDT (IRR=0.91, P < 0.001), and a bad performance at OLB and FTSS (respectively IRR=1.85, P < 0.001 and IRR=1.26, P < 0.001) were related to the recurrence of falls. After adjustment only the advance in age (IRR=1.02, P < 0.001), female gender (IRR=2.15, P < 0.001), clobazam (IRR=2.54, P=0.04), prazepam (IRR=1.63, P=0.03) and OLB (IRR=1.55, P < 0.001) were still significantly related to the number of falls.
The current study shows that the age, the female gender, the use of clobazam or prazepam and a low score at OLB are related to the recurrence of falls.
虽然苯二氮䓬类药物（BZD）与单次跌倒之间的关联早已为人所知，但 BZD 与复发性跌倒之间的关联却鲜为人知。
本研究的目的是 1）在考虑潜在混杂因素影响的情况下，检查 BZD 是否与复发性跌倒有关，2）确定在 65 岁及以上的社区居住的人群中，BZD 和平衡障碍之间是否存在与跌倒风险相关的相互作用。
横断面研究。
法国东北部的三个健康中心。
65 岁及以上的 7643 名社区居住志愿者。
记录 BZD 的使用、简易精神状态检查（MMSE）评分、画钟测验（CDT）、单腿平衡（OLB）测试、五次坐立测试（FTSS）和跌倒史。根据跌倒次数将受试者分为 4 组：0、1、2 和≥3 次跌倒。
在 1456 名（19.2%）跌倒者中，994 名（13.0%）为单次跌倒者，462 名（6.1%）为复发性跌倒者（即>2 次跌倒）。跌倒次数随年龄增长显著增加（发生率比（IRR）=1.04，P<0.001），女性（IRR=2.24，P<0.001），使用苯二氮䓬类药物（IRR=1.65，P<0.001），尤其是使用溴马唑仑（IRR=1.44，P=0.006）、氯巴占（IRR=3.01，P=0.014）和普拉西泮（IRR=2.29，P<0.001）。MMSE 评分较低（IRR=0.96，P<0.001）、CDT 受损（IRR=0.91，P<0.001）和 OLB 和 FTSS 表现不佳（分别为 IRR=1.85，P<0.001 和 IRR=1.26，P<0.001）与跌倒复发有关。调整后，仅年龄增长（IRR=1.02，P<0.001）、女性（IRR=2.15，P<0.001）、氯巴占（IRR=2.54，P=0.04）、普拉西泮（IRR=1.63，P=0.03）和 OLB（IRR=1.55，P<0.001）仍与跌倒次数显著相关。
本研究表明，年龄、女性、氯巴占或普拉西泮的使用以及 OLB 评分较低与跌倒复发有关。
