Sedative use and incidence of falls and hip fractures among older adults in an outpatient geriatric clinic

• Asıl Yazarlar: Nelson Machado do Carmo Júnior (Yazar), Edna Afonso Reis (Yazar), Antônio Ignácio de Loyola Filho (Yazar), Estevão Alves Valle (Yazar), Daniela Castelo Azevedo (Yazar), Mariana Martins Gonzaga do Nascimento (Yazar)
• Materyal Türü: Kitap
• Baskı/Yayın Bilgisi: Brazilian Society of Geriatrics and Gerontology, 2023-05-01T00:00:00Z.
• Konular: article
• Online Erişim: Connect to this object online.
• Notes: 2447-2123; 10.53886/gga.e0230012
• Keywords: aged; hypnotics and sedatives; benzodiazepines; accidental falls; femoral fractures; longitudinal studies; Nursing; RT1-120; Geriatrics; RC952-954.6; Public aspects of medicine; RA1-1270
• Source: Geriatrics, Gerontology and Aging, Vol 17, Pp 1-7 (2023)

Objective: To investigate the use of sedatives by older adults attending a private outpatient geriatric clinic in Belo Horizonte (MG), Brazil, and its association with falls and hip fractures. Methods: Using a longitudinal design, the prevalence of benzodiazepine and nonbenzodiazepine ("z-drugs") intake by older adults was described and their association with the incidence of falls and fractures (30 days after the initial visit) was evaluated through logistic regression. Results: A total of 7821 older adults were included in the study, most of them women (72.50%), with a mean age of 77.5 years and a mean Clinical-Functional Vulnerability Index (IVCF-20) score of 16.5. The overall prevalence of sedative use (any sedative) was 6.19%, with 4.48% benzodiazepines and 1.98% z-drugs. The most widely used sedatives were clonazepam (29.04%), zolpidem (28.65%), and alprazolam (23.44%). Falls were reported for 182 patients (2.33%), with a higher incidence among users of any sedatives (4.34; p = 0.002; OR = 1.94, adjusted for sex, age, and IVCF-20) and benzodiazepines (5.14%; p < 0.001; OR = 2.28) than among non-users (2.19%). Hip fractures occurred in 33 patients (0.42%), and again were more frequent among users of sedatives (1.03%; p = 0.032; OR = 2.57) and benzodiazepines (1.43%; p = 0.003; OR = 3.45) than among non-users (0.38%). Conclusions: The use of sedatives, especially benzodiazepines, is associated with an increased incidence of falls and hip fractures in older adults.