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Insomnia, Benzodiazepine Use, and Falls among Residents in Long-term Care Facilities

Background: Falls are leading cause of injury among older people, especially for those living in long-term care facilities (LTCFs). Very few studies have assessed the effect of sleep quality and hypnotics use on falls, especially in Chinese LTCFs. The study aimed to examine the association between s...

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Autores principales: Jiang, Yu, Xia, Qinghua, Wang, Jie, Zhou, Peng, Jiang, Shuo, Diwan, Vinod K., Xu, Biao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6926709/
https://www.ncbi.nlm.nih.gov/pubmed/31766368
http://dx.doi.org/10.3390/ijerph16234623
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author Jiang, Yu
Xia, Qinghua
Wang, Jie
Zhou, Peng
Jiang, Shuo
Diwan, Vinod K.
Xu, Biao
author_facet Jiang, Yu
Xia, Qinghua
Wang, Jie
Zhou, Peng
Jiang, Shuo
Diwan, Vinod K.
Xu, Biao
author_sort Jiang, Yu
collection PubMed
description Background: Falls are leading cause of injury among older people, especially for those living in long-term care facilities (LTCFs). Very few studies have assessed the effect of sleep quality and hypnotics use on falls, especially in Chinese LTCFs. The study aimed to examine the association between sleep quality, hypnotics use, and falls in institutionalized older people. Methods: We recruited 605 residents from 25 LTCFs in central Shanghai and conducted a baseline survey for sleep quality and hypnotics use, as well as a one-year follow-up survey for falls and injurious falls. Logistic regression models were applied in univariate and multivariate analysis. Results: Among the 605 participants (70.41% women, mean age 84.33 ± 6.90 years), the one-year incidence of falls and injurious falls was 21.82% and 15.21%, respectively. Insomnia (19.83%) and hypnotics use (14.21%) were prevalent. After adjusting for potential confounders, we found that insomnia was significantly associated with an increased risk of falls (adjusted risk ratio (RR): 1.787, 95% CI, 1.106–2.877) and the use of benzodiazepines significantly increased the risk of injurious falls (RR: 3.128, 95% CI, 1.541–6.350). Conclusion: In elderly LTCF residents, both insomnia and benzodiazepine use are associated with an increased risk of falls and injuries. Adopting non-pharmacological approaches to improve sleep quality, taking safer hypnotics, or strengthening supervision on benzodiazepine users may be useful in fall prevention.
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spelling pubmed-69267092019-12-24 Insomnia, Benzodiazepine Use, and Falls among Residents in Long-term Care Facilities Jiang, Yu Xia, Qinghua Wang, Jie Zhou, Peng Jiang, Shuo Diwan, Vinod K. Xu, Biao Int J Environ Res Public Health Article Background: Falls are leading cause of injury among older people, especially for those living in long-term care facilities (LTCFs). Very few studies have assessed the effect of sleep quality and hypnotics use on falls, especially in Chinese LTCFs. The study aimed to examine the association between sleep quality, hypnotics use, and falls in institutionalized older people. Methods: We recruited 605 residents from 25 LTCFs in central Shanghai and conducted a baseline survey for sleep quality and hypnotics use, as well as a one-year follow-up survey for falls and injurious falls. Logistic regression models were applied in univariate and multivariate analysis. Results: Among the 605 participants (70.41% women, mean age 84.33 ± 6.90 years), the one-year incidence of falls and injurious falls was 21.82% and 15.21%, respectively. Insomnia (19.83%) and hypnotics use (14.21%) were prevalent. After adjusting for potential confounders, we found that insomnia was significantly associated with an increased risk of falls (adjusted risk ratio (RR): 1.787, 95% CI, 1.106–2.877) and the use of benzodiazepines significantly increased the risk of injurious falls (RR: 3.128, 95% CI, 1.541–6.350). Conclusion: In elderly LTCF residents, both insomnia and benzodiazepine use are associated with an increased risk of falls and injuries. Adopting non-pharmacological approaches to improve sleep quality, taking safer hypnotics, or strengthening supervision on benzodiazepine users may be useful in fall prevention. MDPI 2019-11-21 2019-12 /pmc/articles/PMC6926709/ /pubmed/31766368 http://dx.doi.org/10.3390/ijerph16234623 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Jiang, Yu
Xia, Qinghua
Wang, Jie
Zhou, Peng
Jiang, Shuo
Diwan, Vinod K.
Xu, Biao
Insomnia, Benzodiazepine Use, and Falls among Residents in Long-term Care Facilities
title Insomnia, Benzodiazepine Use, and Falls among Residents in Long-term Care Facilities
title_full Insomnia, Benzodiazepine Use, and Falls among Residents in Long-term Care Facilities
title_fullStr Insomnia, Benzodiazepine Use, and Falls among Residents in Long-term Care Facilities
title_full_unstemmed Insomnia, Benzodiazepine Use, and Falls among Residents in Long-term Care Facilities
title_short Insomnia, Benzodiazepine Use, and Falls among Residents in Long-term Care Facilities
title_sort insomnia, benzodiazepine use, and falls among residents in long-term care facilities
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6926709/
https://www.ncbi.nlm.nih.gov/pubmed/31766368
http://dx.doi.org/10.3390/ijerph16234623
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