To identify factors associated with sustained benzodiazepine use in older adults.DESIGN
Twelve-year cohort study.SETTING
Community-based epidemiological survey.PARTICIPANTS
One thousand three hundred forty-two individuals aged 65 and older.MEASUREMENTS
Demographics, medication use, depressive symptoms, sleep complaints, alcohol use, and smoking assessed at 2-year intervals; descriptive analysis to characterize benzodiazepine users and identify factors associated with sustained benzodiazepine use (use at two consecutive waves); and longitudinal lag-time analysis to determine characteristics that predicted sustained use.RESULTS
Initially, 5.5% of men and 9.8% of women were using benzodiazepines. Users were significantly more likely than nonusers to be female and less educated, report more depressive and anxiety symptoms, use more prescription medications, have lower self-rated health, have difficulty maintaining sleep, and be less likely to consume alcohol. Approximately 50%, 44%, and 25% of these users aged 65 to 74, 75 to 84, and 85 and older, respectively, were sustained users at follow-up. Being female, using two or more nonbenzodiazepine prescription medications, and smoking were independently associated with subsequent sustained benzodiazepine use.CONCLUSION
At the population level, women, smokers, and users of at least two prescription drugs have higher probabilities of sustaining benzodiazepine use once started. This information can facilitate risk assessment and counseling of older adults before prescribing benzodiazepines.