The use of benzodiazpines and related drugs amongst older people in Sweden: associated factors and concomitant use of other psychotropics

Kristina Johnell, Johan Fastbom
International Journal of Geriatric Psychiatry 2009, 24 (7): 731-8

OBJECTIVE: To determine the factors associated with use of benzodiazepines and benzodiazepine related drugs (BZDs/BZDRDs) in a nationwide population of older people.

METHODS: We analyzed data on age, sex, type of residential area (urban/rural), and dispensed drugs for people aged > or = 75 years registered in the Swedish Prescribed Drug Register from October to December 2005 (n = 731,105; corresponds to 91% of the domain population). Multivariate logistic regression analysis was used for analyzing whether age, sex, type of residential area, number of other drugs, and concomitant psychotropic drug use was associated with use of BZDs/BZDRDs.

RESULTS: > or =1 BZDs/BZDRDs and > or =2 BZDs/BZDRDs were used by 25% and 5% of the study population, respectively. The most commonly used BZDs/BZDRDs were zopiclone, zolpidem, oxazepam, flunitrazepam, and diazepam. The probability of use BZDs/BZDRDs increased with age, female gender, living in an urban area, use of many other drugs, and concomitant use of other psychotropics, particularly antidepressants. In the comparisons of different BZDs/BZDRDs (n = 179,632), the medium-acting BZDs were associated with higher age, female gender, and use of other psychotropics, whereas BZDRDs showed the opposite pattern. Also, the two BZDRDs zopiclone and zolpidem showed different patterns regarding age, sex, and use of other drugs.

CONCLUSIONS: One in four of the elderly used one or more BZD/BZDRD, which should be prescribed cautiously and with the recognition of the potentially negative effects. There were differences in patterns of use for different BZDs/BZDRDs, even within the same drug class. Hence, large study populations are needed for future research of individual BZDs/BZDRDs.

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