de Vries Oscar J, Peeters Geeske, Elders Petra, Sonnenberg Caroline, Muller Majon, Deeg Dorly J H, Lips Paul
Internal Medicine, Section of Geriatric Medicine, VU University Medical Center, De Boelelaan 1117 - 4A35, Amsterdam, Netherlands 1081HV, Netherlands.
Age Ageing. 2013 Nov;42(6):764-70. doi: 10.1093/ageing/aft089. Epub 2013 Jul 30.
the STOPP criteria advise against the use of long-acting benzodiazepines (LBs).
to study whether LBs are associated with a higher fall risk than short-acting benzodiazepines (SBs) (elimination half-life ≤ 10 h).
we used base-line data and prospective fall follow-up from the Longitudinal Aging Study Amsterdam, a longitudinal cohort study including 1,509 community-dwelling older persons (Study 1) and from a separate fall prevention study with 564 older persons after a fall (Study 2). Time to the first fall after inclusion and number of falls in the first year after inclusion were the primary endpoints.
both in Study 1 and Study 2 the use of SBs was associated with time to the first fall, hazard ratio (HR) 1.62 (95% CI: 1.03-2.56) and HR 1.64 (95% CI: 1.19-2.26),respectively. LBs were not significantly associated with time to first fall, HR 1.40 (0.85-2.31) and HR 1.08 (0.72-1.62). In both studies, the use of SBs was also associated with number of falls, odds ratio (OR) 1.28 (95% CI: 1.01-1.61) and OR 1.37 (95% CI: 1.10-1.70). LBs were not significantly associated with number of falls, OR 1.23 (0.96-1.57) and 1.10 (0.82-1.48).
the use of SBs is not associated with a lower fall risk compared with LBs. The use of both SBs and LBs by old persons should be strongly discouraged.
STOPP标准不建议使用长效苯二氮䓬类药物（LBs）。
研究长效苯二氮䓬类药物与短效苯二氮䓬类药物（消除半衰期≤10小时）相比是否具有更高的跌倒风险。
我们使用了阿姆斯特丹纵向衰老研究的基线数据和前瞻性跌倒随访数据，这是一项纵向队列研究，包括1509名社区居住的老年人（研究1）以及另一项针对564名跌倒后老年人的跌倒预防研究（研究2）。纳入后至首次跌倒的时间以及纳入后第一年的跌倒次数为主要终点。
在研究1和研究2中，使用短效苯二氮䓬类药物均与首次跌倒时间相关，风险比（HR）分别为1.62（95%置信区间：1.03 - 2.56）和1.64（95%置信区间：1.19 - 2.26）。长效苯二氮䓬类药物与首次跌倒时间无显著关联，HR为1.40（0.85 - 2.31）和1.08（0.72 - 1.62）。在两项研究中，使用短效苯二氮䓬类药物也与跌倒次数相关，比值比（OR）分别为1.28（95%置信区间：1.01 - 1.61）和1.37（95%置信区间：1.10 - 1.70）。长效苯二氮䓬类药物与跌倒次数无显著关联，OR分别为1.23（0.96 - 1.57）和1.10（0.82 - 1.48）。
与长效苯二氮䓬类药物相比，使用短效苯二氮䓬类药物并不会降低跌倒风险。应强烈不鼓励老年人使用短效和长效苯二氮䓬类药物。
