Financial support was provided by Grant K08AG00808-01 from the National Institute on Aging (Dr. Gray) and from the VFW Endowed Chair in Pharmacotherapy for the Elderly, College of Pharmacy, University of Minnesota (Dr. Artz).
Benzodiazepine Use and Physical Performance in Community-Dwelling Older Women
Article first published online: 24 OCT 2003
Journal of the American Geriatrics Society
Volume 51, Issue 11, pages 1563–1570, November 2003
How to Cite
Gray, S. L., Penninx, B. W. J. H., Blough, D. K., Artz, M. B., Guralnik, J. M., Wallace, R. B., Buchner, D. M. and LaCroix, A. Z. (2003), Benzodiazepine Use and Physical Performance in Community-Dwelling Older Women. Journal of the American Geriatrics Society, 51: 1563–1570. doi: 10.1046/j.1532-5415.2003.51502.x
- Issue published online: 24 OCT 2003
- Article first published online: 24 OCT 2003
- activities of daily living;
- cohort studies
Objectives: To determine whether benzodiazepine use in older women increased the risk of decline in physical function.
Design: A four-year prospective cohort study.
Setting: The communities of Iowa and Washington counties, Iowa.
Participants: Eight hundred eighty-five women aged 70 and older who had completed physical performance tests in 1988 and 1992.
Measurements: 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 (β=–1.16; standard error (SE)=0.25; P<.001). The use of higher-than-recommended dose was related to decline (β=–2.26; SE=0.47; P<.001), and use of lower doses was not (β=–0.53; SE=0.46; P=.246). Long-term use (≥3 years) was related to decline (β=–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.
Conclusion: 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 (≥3 years). These findings highlight the importance of using benzodiazepines at the lowest effective dose for a limited duration in older women.