title: The elimination half-life of benzodiazepines and fall risk: two prospective observational studies.
abstract: BACKGROUND
  the STOPP criteria advise against the use of long-acting benzodiazepines (LBs).
  
  
  OBJECTIVE
  to study whether LBs are associated with a higher fall risk than short-acting benzodiazepines (SBs) (elimination half-life ≤ 10 h).
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Internal Medicine, Section of Geriatric Medicine, VU University Medical Center, De Boelelaan 1117 - 4A35, Amsterdam, Netherlands 1081HV, Netherlands.
authors.forename: Oscar J
authors.initials: OJ
authors.lastname: de Vries
authors.forename: Geeske
authors.initials: G
authors.lastname: Peeters
authors.forename: Petra
authors.initials: P
authors.lastname: Elders
authors.forename: Caroline
authors.initials: C
authors.lastname: Sonnenberg
authors.forename: Majon
authors.initials: M
authors.lastname: Muller
authors.forename: Dorly J H
authors.initials: DJ
authors.lastname: Deeg
authors.forename: Paul
authors.initials: P
authors.lastname: Lips
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001569:Benzodiazepines / Q000009:adverse effects* / Q000493:pharmacokinetics*; D005260:Female; D006207:Half-Life; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects* / Q000493:pharmacokinetics*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D018579:Patient Selection; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D006993:Hypnotics and Sedatives; D001569:Benzodiazepines
keywords: accidental falls; adverse drug events; aged; benzodiazepines; older people; sedatives