Uso de sedativos entre idosos residentes em comunidade: um estudo de tendência.

Abstract

The aging of the Brazilian population leads to an increase in the prevalencer of chronic noncommunicable diseases and the use of medications. Among the medications used by older adults, sedatives stand out, as their safety is affected by the aging process and they are associated with the occurrence of serious adverse events. Therefore, this study aims to evaluate the trend in the use of benzodiazepines and Z-drugs by older adults living in the community. To this end, a trend study was carried out based on two cohorts of older adults (60 years or older) in the municipality of Bambuí (MG): I) referring to the year 1997 (n = 1,494); and II) year 2022 (n = 900). For both, data collection was based on the home application of a standardized questionnaire. The prevalence of the use of benzodiazepine (BZD) sedatives and Z-drugs was calculated for each cohort. The prevalence of the use was compared through univariate and multivariate analyses using Poisson regression model with robust variance, which produces prevalence ratios (PR) and respective 95% confidence interval (95%CI). Factors associated with the use of sedatives in 2022 were also investigated. No statistically significant difference was identified in the overall use of sedatives between the cohorts (PR=1.03; 95%CI=0.82-1.28). Among BZD, there was an increase in the use of alprazolam and clonazepam (PR=12.06; 95%CI=4.69-31.04; and PR=2.56; 95%CI=1.60-4.11, respectively) and a decrease in the use of bromazepam (PR=0.18; 95%CI=0.10-0.31). The use of z-drugs, which was non-existent in 1997, had a prevalence of 4.7% in 2022. The following were positively associated with the use of sedatives in 2022: female gender (PR=1.61; 95%CI=1.13-2.29); regular self-rated health (PR=1.56; 95%CI=1.09-2.24); 5 or more medical appointments per year (PR=1.94; 95%CI=1.16-3.26); and presence of depressive symptoms (PR=2.06; 95%CI=1.50-2.83). A stable frequency of sedative use was identified across the cohorts, despite the considerable increase in the use of some BZD and z-drugs. Given the accumulation of evidence on the risks of sedative use among the elderly over the years, a reduction in their use was expected. Therefore, it is identified that there is still a need to raise awareness among prescribers and users about the risks associated with the use of sedatives, and to implement effective initiatives to deprescribe them.