Hostname: page-component-848d4c4894-p2v8j Total loading time: 0.001 Render date: 2024-05-29T11:15:46.524Z Has data issue: false hasContentIssue false
  • English
  • Français

Sedative–hypnotic drug use among community-dwelling elderly in Taiwan

Published online by Cambridge University Press:  21 March 2018

Han-Yun Tseng ,
Shu-Han Yu ,
Chun-Yi Lee ,
Wen-Hao Huang ,
Seng-Loong Huang ,
Chi-Shin Wu ,
Yen-Feng Chiu  and
Chao A. Hsiung
Han-Yun Tseng
Affiliation:
Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli, Taiwan
Shu-Han Yu
Affiliation:
Aesthetic-Mind Clinic, Taichung, Taiwan
Chun-Yi Lee
Affiliation:
Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli, Taiwan
Wen-Hao Huang
Affiliation:
Department of Medical Administration, Yee Zen General Hospital, Taoyuan, Taiwan
Seng-Loong Huang
Affiliation:
Family Medicine, Community Health Department, Mennonite Christian Hospital, Hualien, Taiwan
Chi-Shin Wu
Affiliation:
Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
Yen-Feng Chiu*
Affiliation:
Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli, Taiwan
Chao A. Hsiung
Affiliation:
Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli, Taiwan
*
Correspondence should be addressed to: Dr. Yen-Feng Chiu, Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli 35053, Taiwan. Phone: +886-37-246166 ext. 36107; Fax: +886-37-586467. Email: yfchiu@nhri.org.tw.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Sedative–hypnotic medication use has been related to severe adverse events and risks. This study investigated the prevalence of and characteristics associated with the use of sedatives and hypnotics among community-dwelling elderly persons aged 65 years and over in Taiwan.

Methods:

A representative sample of community-dwelling adults was recruited. Clinical and sociodemographic data were collected for assessing physical, mental, and cognitive functioning and disorders. Sedatives and hypnotics use was determined via both self-reporting and prescription records. Logistic regression modeling was used to evaluate associations between sedative–hypnotic use and demographic and health status.

Results:

Among the 3,978 participants aged 65 years and over, the rate of sedative–hypnotic use was 19.7% (n = 785). 4.5% (n = 35) of users reported sedative–hypnotic use without a doctor's prescription. Several sociodemographic characteristics were positively associated with sedative and hypnotic use, including older age, female gender, higher education level, married status, unemployment, and current alcohol consumption. Comorbid chronic and cardiovascular diseases, mental illness, depression, pain, and sleep problems also increased the likelihood of sedative–hypnotic use.

Conclusions:

This study is one of the largest pioneer studies to date to survey sedatives–hypnotics use among community-dwelling elderly. One in five community-dwelling older adults reported sedative–hypnotic drugs use in Taiwan, and about 5% of sedative and/or hypnotics usage was without a doctor's prescription. Findings could be helpful for drug-use safety interventions to identify target geriatric patients who are in general at higher risk of downstream harm associated with sedative–hypnotic use in geriatric patients.

Keywords

agingepidemiologypsychogeriatricsrisk factors
Type
Original Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 7: Issue Theme: Benzodiazepines and Hypnotics , July 2018 , pp. 957 - 965
Copyright
Copyright © International Psychogeriatric Association 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

These authors contributed equally to this work.

References

Aparasu, R. R., Mort, J. R. and Brandt, H. (2003). Psychotropic prescription use by community-dwelling elderly in the United States. Journal of American Geriatrics Society, 51, 671–677.Google Scholar
Barbone, F. et al. (1998). Association of road-traffic accidents with benzodiazepine use. The Lancet, 352, 1331–1336.Google Scholar
Billioti de Gage, S. et al. (2012). Benzodiazepine use and risk of dementia: prospective population based study. BMJ, 345, e6231. doi: 10.1136/bmj.e6231.Google Scholar
Center for Substance Abuse Treatment (1998). Substance Abuse among Older Adults: An Invisible Epidemic. Treatment Improvement Protocol (TIP) Series, No. 26. Rockville, MD: Substance Abuse and Mental Health Services Administration. Available at: http://www.ncbi.nlm.nih.gov/books/NBK64422.Google Scholar
Cheng, J. S., Huang, W. F., Lin, K. M. and Shih, Y. T. (2008). Characteristics associated with benzodiazepine usage in elderly outpatients in Taiwan. International Journal of Geriatric Psychiatry, 23, 618–624. doi:10.1002/gps.1950.Google Scholar
Dell'osso, B. and Lader, M. (2013). Do benzodiazepines still deserve a major role in the treatment of psychiatric disorders? A critical reappraisal. European Psychiatry, 28, 7–20. doi:10.1016/j.eurpsy.2011.11.003.Google Scholar
Drummer, O. H. et al. (2004). The involvement of drugs in drivers of motor vehicles killed in Australian road traffic crashes. Accident Analysis and Prevention, 36, 239–248.Google Scholar
Fick, D. M., Hodo, D. M., Lawrence, F. and Inouye, S. K. (2007). Recognizing delirium superimposed on dementia: assessing nurses’ knowledge using case vignettes. Journal of Gerontological Nursing, 33, 40–47; quiz 48–49.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Fourrier, A., Letenneur, L., Dartigues, J. F., Moore, N. and Bégaud, B. (2001). Benzodiazepine use in an elderly community-dwelling population. European Journal of Clinical Pharmacology, 57, 419–425.Google Scholar
Gallacher, J., Elwood, P., Pickering, J., Bayer, A., Fish, M. and Ben-Shlomo, Y. (2012). Benzodiazepine use and risk of dementia: evidence from the Caerphilly Prospective Study (CaPS). Journal of Epidemiology Community Health, 66, 869–873. doi:10.1136/jech-2011-200314.Google Scholar
Glass, J., Lanctot, K. L., Herrmann, N., Sproule, B. A. and Busto, U. E. (2005). Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits. British Medical Journal, 331, 1169. doi:10.1136/bmj.38623.768588.47.Google Scholar
Gleason, P. P. et al. (1998). Correlates and prevalence of benzodiazepine use in community-dwelling elderly. Journal of General Internal Medicine, 13, 243–250.Google Scholar
Gray, S. L., Eggen, A. E., Blough, D., Buchner, D. and LaCroix, A. Z. (2003). Benzodiazepine use in older adults enrolled in a health maintenance organization. American Journal of Geriatric Psychiatry, 11, 568–576.Google Scholar
Hoque, R. and Chesson, A. L. Jr., (2009). Zolpidem-induced sleepwalking, sleep related eating disorder, and sleep-driving: fluorine-18-flourodeoxyglucose positron emission tomography analysis, and a literature review of other unexpected clinical effects of zolpidem. Journal of Clinical Sleep Medicine, 5, 471–476.Google Scholar
Hsiao, F. Y., Hsieh, P.-H. and Gau, C.-S. (2013). Ten-year trend in prescriptions of z-hypnotics among the elderly: a nationwide, cross-sectional study in Taiwan. Journal of Clinical Gerontology and Geriatrics, 4, 37–41. doi: https://doi.org/10.1016/j.jcgg.2012.12.001.Google Scholar
Hsu, C. C. et al. (2017). Cohort profile: the healthy aging longitudinal study in Taiwan (HALST). International Journal of Epidemiology, 46, 1106–1106. doi:10.1093/ije/dyw331.Google Scholar
Kageyama, T. et al. (1998). Prevalence of use of medically prescribed hypnotics among adult Japanese women in urban residential areas. Psychiatry and Clinical Neurosciences, 52, 69–74. doi:10.1111/j.1440-1819.1998.tb00975.x.Google Scholar
Kane, R. L. and Kane, R. A. (2000). Assessing Older Persons: Measures, Meaning, and Practical Applications. New York: Oxford University Press.Google Scholar
Lagnaoui, R. et al. (2004). Patterns and correlates of benzodiazepine use in the French general population. European Journal of Clinical Pharmacology, 60, 523–529. doi:10.1007/s00228-004-0808-2.Google Scholar
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.Google Scholar
Linden, M. and Barnow, S. (1997). The wish to die in very old persons near the end of life: a psychiatric problem? Results from the Berlin Aging Study. International Psychogeriatrics, 9, 291–307. doi: 10.1017/S1041610297004456.Google Scholar
Mayer-Oakes, S. A. et al. (1993). Benzodiazepine use in older, community-dwelling southern Californians: prevalence and clinical correlates. The Annals of Pharmacotherapy 27, 416–421. doi: 10.1177/106002809302700403.Google Scholar
Meng, S. H., Wu, C. H. and Lin, W. D. (2013). The effects of retirement on mental health as measured by the use of hypnotic drugs. Taiwan Journal of Public Health, 32, 52–61. doi: 10.1017/S1041610297004456.Google Scholar
Morgan, K., Dallosso, H., Ebrahim, S., Arie, T. and Fentem, P. H. (1988). Prevalence, frequency, and duration of hypnotic drug use among the elderly living at home. British Medical Journal (Clinical Research Edition), 296, 601–602.Google Scholar
NHIS Working Group (2005). Sampling design for the 2005 National Health Interview Survey. The 2005 National Health Interview Survey Research Brief, 2nd edn. Taipei, Taiwan: National Health Research Institutes & Bureau of Health Promotion (in Chinese). Available at: https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=234&pid=1278.Google Scholar
Paulose-Ram, R., Safran, M. A., Jonas, B. S., Gu, Q. and Orwig, D. (2007). Trends in psychotropic medication use among U.S. adults. Pharmacoepidemiology and Drug Safety 16, 560–570. doi:10.1002/pds.1367.Google Scholar
Radloff, L. S. (1977). The CES-D scale: a self-report depression scale for research in general population. Applied Psychological Measurement, 1, 385–401. doi:10.1177/014662167700100306.Google Scholar
Ried, L. D., Johnson, R. E. and Gettman, D. A. (1998). Benzodiazepine exposure and functional status in older people. Journal of the American Geriatrics Society, 46, 71–76.Google Scholar
Schneeweiss, S. and Wang, P. S. (2005). Claims data studies of sedative‐hypnotics and hip fractures in older people: exploring residual confounding using survey information. Journal of the American Geriatrics Society, 53, 948–954.Google Scholar
Sonnenberg, C. M., Bierman, E. J., Deeg, D. J., Comijs, H. C., van Tilburg, W. and Beekman, A. T. (2012). Ten-year trends in benzodiazepine use in the Dutch population. Social Psychiatry and Psychiatric Epidemiology, 47, 293–301. doi:10.1007/s00127-011-0344-1.Google Scholar
Su, T. P., Huang, S. R. and Chou, P. (2004). Prevalence and risk factors of insomnia in community-dwelling Chinese elderly: a Taiwanese urban area survey. Australian & New Zealand Journal of Psychiatry, 38, 706–713. doi:10.1080/j.1440-1614.2004.01444.x.Google Scholar
Taipale, H. T., Bell, J. S., Gnjidic, D., Sulkava, R. and Hartikainen, S. (2011). Muscle strength and sedative load in community-dwelling people aged 75 years and older: a population-based study. The Journals of Gerontology, Series A, Biological Sciences and Medical Sciences, 66, 1384–1392. doi:10.1093/gerona/glr170.Google Scholar
Verdoux, H., Tournier, M. and Cougnard, A. (2005). Impact of substance use on the onset and course of early psychosis. Schizophrenia Research, 79, 69–75. doi: 10.1016/j.schres.2004.12.008.Google Scholar
Vozoris, N. T. and Leung, R. S. (2011). Sedative medication use: prevalence, risk factors, and associations with body mass index using population-level data. Sleep, 34, 869–874. doi:10.5665/SLEEP.1116.Google Scholar
Windle, A., Elliot, E., Duszynski, K. and Moore, V. (2007). Benzodiazepine prescribing in elderly Australian general practice patients. Australian and New Zealand Journal of Public Health, 31, 379–381.Google Scholar
Wu, C. S., Wang, S. C., Cheng, Y. C. and Gau, S. S. (2011). Association of cerebrovascular events with antidepressant use: a case-crossover study. American Journal of Psychiatry, 168, 511–521. doi: 10.1176/appi.ajp.2010.10071064.Google Scholar
Wu, C. S., Yu, S. H., Lee, C. Y., Tseng, H. Y., Chiu, Y. F. and Hsiung, C. A. (2017). Prevalence of and risk factors for minor and major depression among community-dwelling older adults in Taiwan. International Psychogeriatrics, 29, 1113–1121. doi:10.1017/S1041610217000199.Google Scholar
Zandstra, S. M., Furer, J. W., van de Lisdonk, E. H., Bor, J. H. J., Zitman, F. G. and van Weel, C. (2002). Differences in health status between long-term and short-term benzodiazepine users. British Journal of General Practice, 52, 805–808.Google Scholar
Supplementary material: File

Tseng et al. supplementary material

Table S1

Download Tseng et al. supplementary material(File)
File 16 KB