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ISSN: 2167-7182

Journal of Gerontology & Geriatric Research
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Research Article

Use of Non-Benzodiazepine Sedative Hypnotics and Risk of Falls in Older Men

Susan J Diem1,2*, Susan K. Ewing3, Katie L Stone3, Sonia Ancoli-Israel4, Susan Redline5, and Kristine E Ensrud1,2,6
1 Department of Medicine, University of Minnesota, Minneapolis, MN, USA
2 Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, USA
3 California Pacific Medical Center Research Institute, San Francisco, CA, USA
4 Departments of Psychiatry and Family & Preventive Medicine, University of California – San Diego, La Jolla, CA, USA
5Harvard Medical School, Boston, MA, USA
6 Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
Corresponding Author : Susan J. Diem
Epidemiology Clinical Research Center
University of Minnesota
1100 Washington Avenue S
Suite 20, Minneapolis
MN 55415, USA
Tel: 612626-9199
Fax: 612626-9505
E-mail: [email protected]
Received March 25, 2014; Accepted May 24, 2014; Published May 26, 2014
Citation: Diem SJ, Ewing SK, Stone KL, Ancoli-Israel S, Redline S, et al. (2014) Use of Non-Benzodiazepine Sedative Hypnotics and Risk of Falls in Older Men. J Gerontol Geriat Res 3:158. doi:10.4172/2167-7182.1000158
Copyright: © 2014 Diem SJ et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Background: To ascertain whether use of non-benzodiazepine sedative-hypnotics is associated with risk of falls and compare this to risk of falls associated with use of benzodiazepines.

Methods: Among 4450 community-dwelling men, aged 71 years and older, enrolled in the population-based prospective cohort study, Osteoporotic Fractures in Men (MrOS), use of non-benzodiazepine sedative-hypnotics and benzodiazepines was assessed by interview and verified from medication containers at the third annual visit of the MrOS study. Falls in the subsequent one-year period were ascertained by tri-annual questionnaires and a computerized dictionary used to categorize type of medication.

Results: In age-adjusted models, non-benzodiazepine sedative hypnotic use was associated with an increased risk of any falls (one or more falls) (RR 1.44, 95% CI 1.15, 1.81) and recurrent falls (2 or more falls) (RR 1.51, 95% CI 1.07, 2.14). Use of benzodiazepines was associated with a similar increase in age-adjusted risk of falling. Depressive symptoms, inability to stand from a chair, and instrumental activities of daily living (IADL) impairment modestly attenuated these associations. The association between non-benzodiazepine sedative-hypnotic use and falls was most pronounced among men without a history of falls in the previous year: in a multivariable model controlling for multiple potential confounders, the RR of any falls was 1.74 (95% CI 1.13, 2.68) in this subgroup.

Conclusions: Use of non-benzodiazepine sedative-hypnotics is associated with an increased risk of falls. Nonpharmacologic approaches to sleep disturbances may represent the safest approach to sleep difficulties in older adults.


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