Citation

Masudo C, Ogawa Y, Yamashita N, Mihara K. Yakugaku Zasshi 2019; 139(1): 113-122.

Affiliation

Department of Pharmaceutical Science, Faculty of Pharmacy, Musashino University.

Copyright

(Copyright © 2019, Pharmaceutical Society of Japan)

DOI

10.1248/yakushi.18-00156

PMID

30606917

Abstract

Benzodiazepine receptor agonists (BZDRAs) have been associated with an increased risk of falls in the elderly. However, the association between the elimination half-life (t_1/2) of BZDRAs and the difference between benzodiazepines (BZDs) and non-benzodiazepines (Z-drugs) has not been clarified. By conducting a meta-analysis of observational studies, we compared the risk of falls with respect to 1) short-acting BZDRAs (t_1/2<12 h) vs. long-acting BZDRAs (t_1/2≥12 h) and 2) BZDs vs. Z-drugs in elderly patients. Data were retrieved from MEDLINE, the Cochrane Library, and Igaku Chuo Zasshi. In total, 13 observational studies from 12 articles were included in our study (short-acting BZDRAs, n=12; long-acting BZDRAs, n=9; BZDs, n=13; Z-drugs, n=7). The risk of falls was significantly increased by the use of short-acting BZDRAs [Odds ratio (OR) (95% Confidence interval (CI)): 2.00 (1.46-2.73)], long-acting BZDRAs [OR (95%CI): 2.16 (1.61-2.89)], BZDs [OR (95%CI): 1.67 (1.31-2.13)], and Z-drugs [OR (95%CI): 2.42 (1.35-4.34)] compared to the risk in BZDRAs non-users. The increased risk of falls in elderly patients was similar in each group and unrelated to t_1/2. This study suggested that all BZDRAs including Z-drugs should be avoided in elderly patients.

Language: ja

Keywords

benzodiazepine receptor agonist; elderly; fall; half-life; meta-analysis; observational study