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
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.