Association of Cognitive Impairment With Benzodiazepine Use in the U.S.: An Analysis of Medical Expenditure Panel Survey
Author(s)
Priyesh Sura, MS1, Minji Kim, BS2, Hemalkumar Mehta, MS, PhD2;
1AstraZeneca Canada Inc., Scarborough, ON, Canada, 2Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
1AstraZeneca Canada Inc., Scarborough, ON, Canada, 2Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
Presentation Documents
OBJECTIVES: The American Geriatrics Society’s Beers Criteria recommends avoiding benzodiazepines in older adults due to increased risk of falls, fractures and death. We described time trends in benzodiazepine use and determined the association of cognitive impairment with such use among older adults in the United States (U.S.).
METHODS: We used Medical Expenditure Panel Survey data from 2016 through 2022 and included older adults (age>=65). We defined benzodiazepine use as individuals who had at least one prescription of long- or short-acting benzodiazepines. We defined cognitive impairment based on a question that asked if individuals had difficulty concentrating, remembering and making decisions and ICD-10-CM codes (G30 and F03). We used weighted linear regression models to test for benzodiazepine trends over time. We used a logistic regression model to determine the association of cognitive impairment with benzodiazepine use while controlling for patient characteristics (age, sex, race/ethnicity, education, income, marital status, region, and year).
RESULTS: The number of older adults ranged from 49.9 million (95% confidence interval [CI], 46.8-53.0) to 58.4 million (95% CI, 53.6 - 63.3) from 2016 through 2022. The mean age of the entire cohort was 73.8±6.4 years, 54.7% were female, 75.1% were non-Hispanic White, and 11.7% had cognitive impairment. Benzodiazepine use among older adults declined from 9.0% (95% CI, 8.0-10.0) in 2016 to 4.7% (95% CI, 4.0-5.5) in 2022 (p<0.0001), and also declined among individuals with and without cognitive impairment. Overall, the use of benzodiazepine was greater among people with cognitive impairment than without (11.6% vs. 6.1%). After controlling for patient characteristics, cognitive impairment was significantly associated with an increased risk of benzodiazepine use (OR, 1.92, 95% CI, 1.64-2.25).
CONCLUSIONS: While overall benzodiazepine use among older adults in the U.S. declined over time, those with cognitive impairment faced an elevated risk of receiving potentially inappropriate benzodiazepines.
METHODS: We used Medical Expenditure Panel Survey data from 2016 through 2022 and included older adults (age>=65). We defined benzodiazepine use as individuals who had at least one prescription of long- or short-acting benzodiazepines. We defined cognitive impairment based on a question that asked if individuals had difficulty concentrating, remembering and making decisions and ICD-10-CM codes (G30 and F03). We used weighted linear regression models to test for benzodiazepine trends over time. We used a logistic regression model to determine the association of cognitive impairment with benzodiazepine use while controlling for patient characteristics (age, sex, race/ethnicity, education, income, marital status, region, and year).
RESULTS: The number of older adults ranged from 49.9 million (95% confidence interval [CI], 46.8-53.0) to 58.4 million (95% CI, 53.6 - 63.3) from 2016 through 2022. The mean age of the entire cohort was 73.8±6.4 years, 54.7% were female, 75.1% were non-Hispanic White, and 11.7% had cognitive impairment. Benzodiazepine use among older adults declined from 9.0% (95% CI, 8.0-10.0) in 2016 to 4.7% (95% CI, 4.0-5.5) in 2022 (p<0.0001), and also declined among individuals with and without cognitive impairment. Overall, the use of benzodiazepine was greater among people with cognitive impairment than without (11.6% vs. 6.1%). After controlling for patient characteristics, cognitive impairment was significantly associated with an increased risk of benzodiazepine use (OR, 1.92, 95% CI, 1.64-2.25).
CONCLUSIONS: While overall benzodiazepine use among older adults in the U.S. declined over time, those with cognitive impairment faced an elevated risk of receiving potentially inappropriate benzodiazepines.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH109
Topic
Epidemiology & Public Health
Topic Subcategory
Safety & Pharmacoepidemiology
Disease
SDC: Geriatrics