Effects of discontinuing benzodiazepine-derivative hypnotics on postural sway and cognitive functions in the elderly

Kenichi Tsunoda, Hiroyuki Uchida, Takefumi Suzuki, Koichiro Watanabe, Tetsumori Yamashima, Haruo Kashima

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Objective: Benzodiazepines (BZDs) have been reported to cause negative impacts on body stability and cognitive functions, which in turn could result in lethal incidents, including falls, especially in the elderly. This fact notwithstanding, no systematic trial has evaluated the feasibility and benefits of discontinuing BZD-derivative hypnotics in this population, which was addressed in this study. Methods In this 8-week open-label study, subjects aged ≥60 living in a nursing home who received BZD as a hypnotic were recruited. The BZD dose was tapered off over 3 weeks. The following assessments were performed 12 h post-dose at baseline and at endpoint: the Clinical Stabilometric Platform (CSP), the Critical Flicker Fusion Test (CFF), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and the Leeds Sleep Evaluation Questionnaire (LSEQ). Results Thirty subjects were enrolled (mean ± SD age = 79.1 ± 8.9 years, mean ± SD flurazepam equivalent BZD dose = 19.5 ± 10.9 mg/day). Psychiatric diagnoses (DSM-IV) of subjects were as follows: schizophrenia (n = 12), primary insomnia (n = 9), dementia (n = 7), and bipolar disorder (n = 2). In 26 completers, significant changes were found in a total length and a range of trunk motion with eyes closed. Significant improvements were also observed in the CFF and RBANS immediate memory, language, and attention index scores. Subjective worsening in sleep was not reported in those completers, assessed with the LSEQ. Conclusions Our results suggest that discontinuation of BZD hypnotics is feasible in a majority of elderly persons and leads to an improvement in the stability of body and a recovery in cognitive functions during the daytime.

Original languageEnglish
Pages (from-to)1259-1265
Number of pages7
JournalInternational Journal of Geriatric Psychiatry
Volume25
Issue number12
DOIs
Publication statusPublished - 2010 Dec

Fingerprint

Hypnotics and Sedatives
Benzodiazepines
Cognition
Flicker Fusion
Sleep
Flurazepam
Sleep Initiation and Maintenance Disorders
Articular Range of Motion
Nursing Homes
Bipolar Disorder
Short-Term Memory
Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders
Dementia
Schizophrenia
Language
Population

Keywords

  • benzodiazepine
  • cognitive function
  • elderly
  • hypnotic
  • postural sway
  • side effect

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

Effects of discontinuing benzodiazepine-derivative hypnotics on postural sway and cognitive functions in the elderly. / Tsunoda, Kenichi; Uchida, Hiroyuki; Suzuki, Takefumi; Watanabe, Koichiro; Yamashima, Tetsumori; Kashima, Haruo.

In: International Journal of Geriatric Psychiatry, Vol. 25, No. 12, 12.2010, p. 1259-1265.

Research output: Contribution to journalArticle

Tsunoda, Kenichi ; Uchida, Hiroyuki ; Suzuki, Takefumi ; Watanabe, Koichiro ; Yamashima, Tetsumori ; Kashima, Haruo. / Effects of discontinuing benzodiazepine-derivative hypnotics on postural sway and cognitive functions in the elderly. In: International Journal of Geriatric Psychiatry. 2010 ; Vol. 25, No. 12. pp. 1259-1265.
@article{ef7bc20183bd47c1bb82ccea9827f010,
title = "Effects of discontinuing benzodiazepine-derivative hypnotics on postural sway and cognitive functions in the elderly",
abstract = "Objective: Benzodiazepines (BZDs) have been reported to cause negative impacts on body stability and cognitive functions, which in turn could result in lethal incidents, including falls, especially in the elderly. This fact notwithstanding, no systematic trial has evaluated the feasibility and benefits of discontinuing BZD-derivative hypnotics in this population, which was addressed in this study. Methods In this 8-week open-label study, subjects aged ≥60 living in a nursing home who received BZD as a hypnotic were recruited. The BZD dose was tapered off over 3 weeks. The following assessments were performed 12 h post-dose at baseline and at endpoint: the Clinical Stabilometric Platform (CSP), the Critical Flicker Fusion Test (CFF), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and the Leeds Sleep Evaluation Questionnaire (LSEQ). Results Thirty subjects were enrolled (mean ± SD age = 79.1 ± 8.9 years, mean ± SD flurazepam equivalent BZD dose = 19.5 ± 10.9 mg/day). Psychiatric diagnoses (DSM-IV) of subjects were as follows: schizophrenia (n = 12), primary insomnia (n = 9), dementia (n = 7), and bipolar disorder (n = 2). In 26 completers, significant changes were found in a total length and a range of trunk motion with eyes closed. Significant improvements were also observed in the CFF and RBANS immediate memory, language, and attention index scores. Subjective worsening in sleep was not reported in those completers, assessed with the LSEQ. Conclusions Our results suggest that discontinuation of BZD hypnotics is feasible in a majority of elderly persons and leads to an improvement in the stability of body and a recovery in cognitive functions during the daytime.",
keywords = "benzodiazepine, cognitive function, elderly, hypnotic, postural sway, side effect",
author = "Kenichi Tsunoda and Hiroyuki Uchida and Takefumi Suzuki and Koichiro Watanabe and Tetsumori Yamashima and Haruo Kashima",
year = "2010",
month = "12",
doi = "10.1002/gps.2465",
language = "English",
volume = "25",
pages = "1259--1265",
journal = "International Journal of Geriatric Psychiatry",
issn = "0885-6230",
publisher = "John Wiley and Sons Ltd",
number = "12",

}

TY - JOUR

T1 - Effects of discontinuing benzodiazepine-derivative hypnotics on postural sway and cognitive functions in the elderly

AU - Tsunoda, Kenichi

AU - Uchida, Hiroyuki

AU - Suzuki, Takefumi

AU - Watanabe, Koichiro

AU - Yamashima, Tetsumori

AU - Kashima, Haruo

PY - 2010/12

Y1 - 2010/12

N2 - Objective: Benzodiazepines (BZDs) have been reported to cause negative impacts on body stability and cognitive functions, which in turn could result in lethal incidents, including falls, especially in the elderly. This fact notwithstanding, no systematic trial has evaluated the feasibility and benefits of discontinuing BZD-derivative hypnotics in this population, which was addressed in this study. Methods In this 8-week open-label study, subjects aged ≥60 living in a nursing home who received BZD as a hypnotic were recruited. The BZD dose was tapered off over 3 weeks. The following assessments were performed 12 h post-dose at baseline and at endpoint: the Clinical Stabilometric Platform (CSP), the Critical Flicker Fusion Test (CFF), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and the Leeds Sleep Evaluation Questionnaire (LSEQ). Results Thirty subjects were enrolled (mean ± SD age = 79.1 ± 8.9 years, mean ± SD flurazepam equivalent BZD dose = 19.5 ± 10.9 mg/day). Psychiatric diagnoses (DSM-IV) of subjects were as follows: schizophrenia (n = 12), primary insomnia (n = 9), dementia (n = 7), and bipolar disorder (n = 2). In 26 completers, significant changes were found in a total length and a range of trunk motion with eyes closed. Significant improvements were also observed in the CFF and RBANS immediate memory, language, and attention index scores. Subjective worsening in sleep was not reported in those completers, assessed with the LSEQ. Conclusions Our results suggest that discontinuation of BZD hypnotics is feasible in a majority of elderly persons and leads to an improvement in the stability of body and a recovery in cognitive functions during the daytime.

AB - Objective: Benzodiazepines (BZDs) have been reported to cause negative impacts on body stability and cognitive functions, which in turn could result in lethal incidents, including falls, especially in the elderly. This fact notwithstanding, no systematic trial has evaluated the feasibility and benefits of discontinuing BZD-derivative hypnotics in this population, which was addressed in this study. Methods In this 8-week open-label study, subjects aged ≥60 living in a nursing home who received BZD as a hypnotic were recruited. The BZD dose was tapered off over 3 weeks. The following assessments were performed 12 h post-dose at baseline and at endpoint: the Clinical Stabilometric Platform (CSP), the Critical Flicker Fusion Test (CFF), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and the Leeds Sleep Evaluation Questionnaire (LSEQ). Results Thirty subjects were enrolled (mean ± SD age = 79.1 ± 8.9 years, mean ± SD flurazepam equivalent BZD dose = 19.5 ± 10.9 mg/day). Psychiatric diagnoses (DSM-IV) of subjects were as follows: schizophrenia (n = 12), primary insomnia (n = 9), dementia (n = 7), and bipolar disorder (n = 2). In 26 completers, significant changes were found in a total length and a range of trunk motion with eyes closed. Significant improvements were also observed in the CFF and RBANS immediate memory, language, and attention index scores. Subjective worsening in sleep was not reported in those completers, assessed with the LSEQ. Conclusions Our results suggest that discontinuation of BZD hypnotics is feasible in a majority of elderly persons and leads to an improvement in the stability of body and a recovery in cognitive functions during the daytime.

KW - benzodiazepine

KW - cognitive function

KW - elderly

KW - hypnotic

KW - postural sway

KW - side effect

UR - http://www.scopus.com/inward/record.url?scp=78649652813&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78649652813&partnerID=8YFLogxK

U2 - 10.1002/gps.2465

DO - 10.1002/gps.2465

M3 - Article

VL - 25

SP - 1259

EP - 1265

JO - International Journal of Geriatric Psychiatry

JF - International Journal of Geriatric Psychiatry

SN - 0885-6230

IS - 12

ER -