Benzodiazepine use and physical performance in community-dwelling older women.
OBJECTIVE
To determine whether benzodiazepine use in older women increased the risk of decline in physical function.


METHODS
A four-year prospective cohort study.


METHODS
The communities of Iowa and Washington counties, Iowa.


METHODS
Eight hundred eighty-five women aged 70 and older who had completed physical performance tests in 1988 and 1992.


METHODS
Benzodiazepine use was determined during in-home interviews and classified by dose, duration, indication for use, and half-life. Physical performance tests included an assessment of standing balance, walking speed (8-foot distance), and repeated chair raises.


RESULTS
Ninety (10.2%) reported benzodiazepine use at baseline. After adjustment for baseline physical performance score and potential confounders, benzodiazepine use was associated with a greater decline in physical performance over 4 years than nonuse (beta=-1.16; standard error (SE)=0.25; P<.001). The use of higher-than-recommended dose was related to decline (beta=-2.26; SE=0.47; P<.001), and use of lower doses was not (beta=-0.53; SE=0.46; P=.246). Long-term use (>or=3 years) was related to decline (beta=-1.65; SE=0.34; P<.001), whereas recent and past use were not. Similar results were obtained when restricting the sample to those without disability at baseline.


CONCLUSIONS
This study provides evidence that older women who used benzodiazepines were at risk for decline in physical performance. Subgroup analyses indicated that risk was greater with use of higher-than-recommended doses or for long duration (>or=3 years). These findings highlight the importance of using benzodiazepines at the lowest effective dose for a limited duration in older women.
Gray
Shelly L
SL
School of Pharmacy, University of Washington, Seattle, Washington 98195, USA. slgray@u.washington.edu
Penninx
Brenda W J H
BW
Blough
David K
DK
Artz
Margaret B
MB
Guralnik
Jack M
JM
Wallace
Robert B
RB
Buchner
Dave M
DM
LaCroix
Andrea Z
AZ
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000188:drug therapy; D001569:Benzodiazepines / Q000009:adverse effects* / Q000627:therapeutic use; D015331:Cohort Studies; D003196:Computer Graphics; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D016014:Linear Models; D009043:Motor Activity / Q000187:drug effects*; D010809:Physical Fitness; D011446:Prospective Studies
D001569:Benzodiazepines