Miami VA Healthcare System Geriatric Research, Education and Clinical Center (GRECC), Veterans Successful Aging for Frail Elders (VSAFE), Bruce W. Carter Miami VAMC, GRECC (11GRC), 1201 NW 16th Street, Miami, FL, 33125, USA.
University of Miami Miller School of Medicine, Miami, FL, USA.
Aging Clin Exp Res. 2022 Aug;34(8):1837-1843. doi: 10.1007/s40520-022-02125-9. Epub 2022 May 6.
Frailty, a clinical syndrome characterized by vulnerability to stressors resulting from multisystemic loss of physiological reserve. The use of benzodiazepines in older adults has been associated with confusion, sedation, and cognitive impairment, which in turn may lead to frailty.
The purpose of this study was to determine the cross-sectional association between frailty and chronic past or current use of benzodiazepine drugs among older US Veterans.
METHODS/DESIGN: This is a cross-sectional study of community-dwelling older Veterans who had determinations of frailty. Benzodiazepine prescription data were obtained via EHR. A 31-item VA Frailty Index (VA-FI) was generated at the time of the assessment. We categorized Veterans into robust (FI ≤ 0.10), pre-frail (FI 0.10-0.21), and Frail (FI ≥ 0.21). After adjusting for sociodemographic characteristics, we calculated ORs and 95% CIs using a binomial logistic regression (BLR) model to assess the cross-sectional association between benzodiazepine use and frailty.
Population sample consisted of 17,423 Veterans, mean age 75.53 (SD = 8.03) years, 70.80% Caucasian, 97.34% male, 14,545 (83.50%) patients were non-users of benzodiazepine drugs, 2408 (13.80%) had a past use, and 470 (2.70%) were current users. In BLR, individuals with past (OR 2.51, 95% CI 2.30-2.74, p < .001) or current (OR 2.36, 95% CI 1.96-2.83, p < .001) use showed a higher association with frailty as compared to individuals who were non-users.
The use of benzodiazepine was cross-sectionally associated with frailty in older Veterans. These results suggest that screening for frailty in patients with past or current exposure to benzodiazepine medications may be necessary for proper management.
衰弱是一种临床综合征，其特征是由于多系统生理储备的丧失而容易受到应激源的影响。在老年人中使用苯二氮䓬类药物与意识混乱、镇静和认知障碍有关，而这些反过来又可能导致衰弱。
本研究旨在确定美国老年退伍军人中衰弱与慢性既往或当前使用苯二氮䓬类药物之间的横断面关联。
方法/设计：这是一项对居住在社区的老年退伍军人进行衰弱评估的横断面研究。通过电子健康记录（EHR）获取苯二氮䓬类药物处方数据。在评估时生成了 31 项退伍军人事务部衰弱指数（VA-FI）。我们将退伍军人分为强壮（FI≤0.10）、虚弱前期（FI 0.10-0.21）和虚弱（FI≥0.21）。在调整社会人口统计学特征后，我们使用二项逻辑回归（BLR）模型计算比值比（OR）和 95%置信区间（CI），以评估苯二氮䓬类药物使用与衰弱之间的横断面关联。
研究人群样本由 17423 名退伍军人组成，平均年龄 75.53（SD=8.03）岁，70.80%为白种人，97.34%为男性，14545 名（83.50%）患者为非苯二氮䓬类药物使用者，2408 名（13.80%）有既往使用史，470 名（2.70%）为当前使用者。在 BLR 中，与非使用者相比，有既往（OR 2.51，95%CI 2.30-2.74，p<.001）或当前（OR 2.36，95%CI 1.96-2.83，p<.001）使用史的个体与衰弱的关联更高。
在老年退伍军人中，苯二氮䓬类药物的使用与衰弱存在横断面关联。这些结果表明，对于有苯二氮䓬类药物用药史或正在使用的患者，筛查衰弱可能是必要的，以便进行适当的管理。
