Study, Jun/19: Psychoactive medic'n use among older community-dwelling Americans

[[La...]]

The full title of this American study is "Psychoactive medication use among older community-dwelling Americans".

 

https://www.ncbi.nlm.nih.gov/pubmed/31204201 

 

Abstract

 

BACKGROUND:

 

Falls are a common and serious health issue among older Americans. A common fall risk factor is the use of psychoactive medications. There is limited recent information on the national prevalence of psychoactive medication use among older Americans.

 

OBJECTIVES:

 

To estimate the prevalence of psychoactive medication use among community-dwelling older Americans and compare it with previous estimates from 1996.

 

METHODS:

 

The data source was the 2013 Cost and Use Data files combining Medicare claims data and survey data from the Medicare Current Beneficiary Survey, an in-person nationally representative survey of Medicare beneficiaries. Participants were included if they were 65 years of age and older, lived in the community, and had a complete year of prescription use data. Medication use was examined for 7 classes of psychoactive medications categorized by the 2015 American Geriatric Society Beers criteria as increasing fall risk. These include opioids, benzodiazepines, selective serotonin reuptake inhibitors, anticonvulsants, nonbenzodiazepine sedative hypnotics, antipsychotics, and tricyclic antidepressants. Data on participant demographic factors were also collected.

 

RESULTS:

 

Among the 6959 community-dwelling older adults studied, representing 33,268,104 community-dwelling Medicare beneficiaries, 53.3% used at least 1 psychoactive medication linked to falls in 2013. The most frequently used medication classes were opioids (34.9%), benzodiazepines (15.4%), selective serotonin reuptake inhibitors (14.3%), and anticonvulsants (13.3%). These estimates are considerably higher for all classes except tricyclic antidepressants than previous reports from 1996 that used the same data source. Among most psychoactive medication classes observed, women had higher usage than men.

 

CONCLUSION:

 

More than half of all older Americans used at least 1 psychoactive medication in 2013. Health care providers, including pharmacists, play a vital role in managing older adults' exposure to psychoactive medications. Medication management can optimize health and reduce older adult falls.

[[Do...]]

yes...Huge problem in assisted living, nursing homes and older folks living in own homes.  Anxiety is so prevalent among our aging population.  We are facing all sorts of issues involving losing independence, health anxiety, loss of loved ones and on and on.  Of course doc's go straight to the prescriptions to solve these problems.  It only creates new problems for so many.  Falls are so common.  So is benzo tolerance and w/d which may be causing falls. Seen it too often.

[[La...]]

Yes, that's true, DoveLuv. I've come across so many studies on this topic, and it just seems like it's rampant. The missing piece of info in these studies tends to be the discussion about what precedes the fall -- that is, dizziness and imbalance. All of the medications listed affect balance, and that's why they make people fall. I wish they'd spell it out in abstracts like these, because it has to do with the effect of the meds on the vestibular system. And these effects can persist even after discontinuation, as many of us around here know.

[[Te...]]

More than half of all older Americans used at least 1 psychoactive medication in 2013.

 

This is quite frightening. In the morning I see many people with canes or hobbling around.  Doctors also are more apt to give an older person a number of pills which all have side effects and interactions, which the doctors usually aren't aware of, as they affect each person in different ways. Older people also have problems with weather changes - a very warm climate could make a person extra dizzy and cause falls.

 

I'm so aware of this now. I went out grocery shopping today and felt unsteady. My head is swirling. I have to stay in and don't like it.

 

What about, as you said, Lapis, the effects lasting for years after the benzos (or other psychoactive medication)? Would doctors believe that?