title: Benzodiazepine use and physical disability in community-dwelling older adults.
abstract: OBJECTIVE
  To determine whether benzodiazepine use is associated with incident disability in mobility and activities of daily living (ADLs) in older individuals.
  
  
  METHODS
  A prospective cohort study.
  
  
  METHODS
  Four sites of the Established Populations for Epidemiologic Studies of the Elderly.
  
  
  METHODS
  This study included 9,093 subjects (aged > or =65) who were not disabled in mobility or ADLs at baseline.
  
  
  METHODS
  Mobility disability was defined as inability to walk half a mile or climb one flight of stairs. ADL disability was defined as inability to perform one or more basic ADLs (bathing, eating, dressing, transferring from a bed to a chair, using the toilet, or walking across a small room). Trained interviewers assessed outcomes annually.
  
  
  RESULTS
  At baseline, 5.5% of subjects reported benzodiazepine use. In multivariable models, benzodiazepine users were 1.23 times as likely as nonusers (95% confidence interval (CI) = 1.09-1.39) to develop mobility disability and 1.28 times as likely (95% CI = 1.09-1.52) to develop ADL disability. Risk for incident mobility was increased with short- (hazard ratio (HR) = 1.27, 95% CI = 1.08-1.50) and long-acting benzodiazepines (HR = 1.20, 95% CI = 1.03-1.39) and no use. Risk for ADL disability was greater with short- (HR = 1.58, 95% CI = 1.25-2.01) but not long-acting (HR = 1.11, 95% CI = 0.89-1.39) agents than for no use.
  
  
  CONCLUSIONS
  Older adults taking benzodiazepines have a greater risk for incident mobility and ADL disability. Use of short-acting agents does not appear to confer any safety benefits over long-acting agents.
authors.affiliation: School of Pharmacy, University of Washington, Seattle, Washington 98195, USA. slgray@u.washington.edu
authors.forename: Shelly L
authors.initials: SL
authors.lastname: Gray
authors.forename: Andrea Z
authors.initials: AZ
authors.lastname: LaCroix
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Hanlon
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
authors.forename: David K
authors.initials: DK
authors.lastname: Blough
authors.forename: Suzanne G
authors.initials: SG
authors.lastname: Leveille
authors.forename: Margaret B
authors.initials: MB
authors.lastname: Artz
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
authors.forename: Dave M
authors.initials: DM
authors.lastname: Buchner
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001007:Anxiety / Q000188:drug therapy* / Q000453:epidemiology; D001569:Benzodiazepines / Q000627:therapeutic use*; D006233:Persons with Disabilities / Q000534:rehabilitation / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D011159:Population Surveillance; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
chemical_list: D001569:Benzodiazepines