Around 5% of U.S. adults use benzodiazepines, such as lorazepam, alprazolam, and diazepam, but that number increases to almost 10% for adults age 65 or older, according to the results of a study published in the February 2015 issue of JAMA Psychiatry. The study, which used the LifeLink LRx Longitudinal Prescription database to retrospectively analyze all of the benzodiazepine prescriptions for adults age 18 to 80 in 2008, found that the percentage of individuals who used benzodiazepines increased with age from 2.6% (18 to 35 years) to 5.4% (36 to 50 years) to 7.4% (51 to 64 years) to 8.7% (65 to 80 years). Relatedly, the proportion of adults engaging in long-term benzodiazepine use (120 days or more) was also observed to increase with age, ranging from 14.7% at 18 to 35 years to 31.4% at 65 to 80 years; however, the proportion who received their benzodiazepine prescription from a psychiatrist decreased with age from 15.0% at 18 to 35 years to 5.7% at 65 to 80 years. Additional results included that benzodiazepine use was nearly twice as prevalent in women as in men and that roughly one-quarter of the individuals receiving benzodiazepines from all age groups were prescribed a long-acting benzodiazepine. The researchers note that, despite cautions concerning risks associated with long-term benzodiazepine use in older patients, it remains common in this age group. They conclude that more vigorous clinical interventions supporting judicious benzodiazepine use may be needed to decrease rates of long-term benzodiazepine use in older adults. A February 13, 2015, New York Times article provides additional coverage of the study and discusses the dangers of long-term benzodiazepine use among older adults, including increased risks of falls and fractures, auto accidents, and reduced cognition.

HRC Recommends: Tools are available to help practitioners be mindful in the prescription of medications to older adults, who are often at risk of polypharmacy and the prescription of inappropriate medications. For example, the Beers criteria lists inappropriate medications for patient categories of older adults. Healthcare organizations should review prescribing practices for older adult patients and ensure that communication across care delivery systems includes accurate and current medication regimens for all patients, especially for older adults.