Prescription use of benzodiazepines — a widely used class of sedative and anti-anxiety medications
— increases steadily with age, despite the known risks for older people, according to a
comprehensive analysis of benzodiazepine prescribing in the United States. Given existing
guidelines cautioning health providers about benzodiazepine use among older adults, findings from
the National Institutes of Health-funded study raise questions about why so many prescriptions —
many for long-term use — are being written for this age group.
The study found that among all adults 18 to 80 years old, about 1 in 20 received a benzodiazepine
prescription in 2008, the period covered by the study. But this fraction rose substantially with
age, from 2.6 percent among those 18 to 35, to 8.7 percent in those 65 to 80, the oldest group
studied. Long-term use — a supply of the medication for more than 120 days — also increased
markedly with age. Of people 65 to 80 who used benzodiazepines, 31.4 percent received prescriptions
for long-term use, vs. 14.7 percent of users 18 to 35. In all age groups, women were about twice as
likely as men to receive benzodiazepines. Among women 65 to 80 years old, 1 in 10 was prescribed
one of these medications, with almost a third of those receiving long-term prescriptions.
The most common uses of benzodiazepines are to treat anxiety and sleep problems. While effective
for both conditions, the medications have risks, especially when used over long periods. Long-term
use can lead to dependence and withdrawal symptoms when discontinued. In older people, research has
shown that benzodiazepines can impair cognition, mobility, and driving skills, and they increase
the risk of falls. Adding to concerns about the possible health consequences of benzodiazepine
use, a recently reported study
association between benzodiazepine use in older people and increased risk of Alzheimer’s disease.
The association was stronger with increasing length of use; the risk was nearly doubled for those
using benzodiazepines for more than 180 days.