Benzodiazepines and falling injuries in the elderly

Objective: To investigate the use of benzodiazepines (BD) in relation to the risk of falling injuries in an elderly population (65 yrs. or older) Design: An unmatched case-control study. Setting: The town of Pori, Finland Participants: 380 subjects aged 65 years or over, who presented for medical treatment due to a fall during the 12 months from Sept. 1987 to Aug. 1988, and 342 controls, 65 years or older, selected from the population register. The control subjects were examined according to a schedule that corresponded in time (time of day, day of the week and month) to the time-distribution of falls in an earlier study Outcome measure: All falls leading to medical treatment. BD use was determined from the serum, and the type of BD was determined by interviews and controlled from patient records Results: We found a tendency toward a dose-response relationship between the serum BD concentration and the occurrence of falling injury. The risk of faling injury related to short-acting BDs was increased 5-fold and that for other BDs 2-fold compared to the risk among those without any BD in the serum. Conclusion: The results indicate that BD use is associated with falls in the elderly, and that short-acting BDs seem to be associated with falls more often. The results suggest caution in the use of BDs in the elderly.