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Hypnotics and mortality in an elderly general population: a 12-year prospective study
Isabelle Jaussent1, Marie-Laure Ancelin, Claudine Berr
1Inserm, U1061, Montpellier F-34000, France. ydauvilliers@yahoo.fr.
BMC Medicine
|September 28, 2013
Summary
Hypnotic drug use in the elderly is not linked to increased mortality when controlling for underlying health issues. Psychiatric disorders, not hypnotics, appear to be the main confounding factors in previous studies.
Area of Science:
- Gerontology
- Pharmacology
- Public Health
Background:
- Hypnotic use is prevalent among the elderly, but its association with mortality is debated.
- Previous studies may be confounded by unaddressed sleep disorders, psychiatric conditions, and other health issues.
Purpose of the Study:
- To investigate the association between hypnotic use and mortality risk in community-dwelling elderly individuals.
- To account for a comprehensive range of potential confounders, including sociodemographic factors, lifestyle, chronic diseases, and psychiatric/sleep complaints.
Main Methods:
- A cohort of 6,696 elderly participants (≥65 years) without dementia was recruited from three French cities.
- Adjusted Cox proportional hazards models with delayed entry were used to analyze the association between hypnotic use and 12-year survival.
Main Results:
- Initially, hypnotic use, especially benzodiazepines, showed a significant association with increased all-cause and cardiovascular mortality.
- However, after adjusting for sociodemographic, lifestyle, chronic, sleep, and psychiatric disorders, these associations were no longer significant.
- Results were consistent regardless of hypnotic intake duration or pattern (persistent vs. intermittent).
Conclusions:
- The apparent increased mortality risk associated with hypnotic use in the elderly is not significant when controlling for a wide array of potential confounders.
- Underlying psychiatric disorders are identified as the primary confounding factors in previous research linking hypnotics to mortality.
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