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Postural Instability and Consequent Falls and Hip Fractures Associated with Use of Hypnotics in the Elderly

Overview of attention for article published in Drugs & Aging, September 2012
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (90th percentile)
  • High Attention Score compared to outputs of the same age and source (91st percentile)

Mentioned by

news
1 news outlet
policy
1 policy source
wikipedia
7 Wikipedia pages

Citations

dimensions_citation
173 Dimensions

Readers on

mendeley
151 Mendeley
connotea
1 Connotea
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Title
Postural Instability and Consequent Falls and Hip Fractures Associated with Use of Hypnotics in the Elderly
Published in
Drugs & Aging, September 2012
DOI 10.2165/00002512-200522090-00004
Pubmed ID
Authors

Hervé Allain, Danièle Bentué-Ferrer, Elisabeth Polard, Yvette Akwa, Alain Patat

Abstract

The aim of this review is to establish the relationship between treatment with hypnotics and the risk of postural instability and as a consequence, falls and hip fractures, in the elderly. A review of the literature was performed through a search of the MEDLINE, Ingenta and PASCAL databases from 1975 to 2005. We considered as hypnotics only those drugs approved for treating insomnia, i.e. some benzodiazepines and the more recently launched 'Z'-compounds, i.e. zopiclone, zolpidem and zaleplon. Large-scale surveys consistently report increases in the frequency of falls and hip fractures when hypnotics are used in the elderly (2-fold risk). Benzodiazepines are the major class of hypnotics involved in this context; falls and fractures in patients taking Z-compounds are less frequently reported, and in this respect, zolpidem is considered as at risk in only one study. It is important to note, however, that drug adverse effect relationships are difficult to establish with this type of epidemiological data-mining. On the other hand, data obtained in laboratory settings, where confounding factors can be eliminated, prove that benzodiazepines are the most deleterious hypnotics at least in terms of their effects on body sway. Z-compounds are considered safer, probably because of their pharmacokinetic properties as well as their selective pharmacological activities at benzodiazepine-1 (BZ(1)) receptors. The effects of hypnotics on balance, gait and equilibrium are the consequence of differential negative impacts on vigilance and cognitive functions, and are highly dose- and time-dependent. Z-compounds have short half-lives and have less cognitive and residual effects than older medications. Some practical rules need to be followed when prescribing hypnotics in order to prevent falls and hip fractures as much as possible in elderly insomniacs, whether institutionalised or not. These are: (i) establish a clear diagnosis of the sleep disorder; (ii) take into account chronic conditions leading to balance and gait difficulties (motor and cognitive status); (iii) search for concomitant prescription of psychotropics and sedatives; (iv) use half the recommended adult dosage; and (v) declare any adverse effect to pharmacovigilance centres. Comparative pharmacovigilance studies focused on the impact of hypnotics on postural stability are very much needed.

Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 151 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 4 3%
France 1 <1%
Netherlands 1 <1%
Brazil 1 <1%
Australia 1 <1%
Unknown 143 95%

Demographic breakdown

Readers by professional status Count As %
Student > Master 19 13%
Researcher 18 12%
Student > Doctoral Student 18 12%
Student > Ph. D. Student 16 11%
Professor 11 7%
Other 37 25%
Unknown 32 21%
Readers by discipline Count As %
Medicine and Dentistry 46 30%
Nursing and Health Professions 15 10%
Pharmacology, Toxicology and Pharmaceutical Science 9 6%
Agricultural and Biological Sciences 8 5%
Psychology 8 5%
Other 25 17%
Unknown 40 26%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 13. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 November 2023.
All research outputs
#2,655,695
of 25,373,627 outputs
Outputs from Drugs & Aging
#156
of 1,293 outputs
Outputs of similar age
#17,891
of 187,169 outputs
Outputs of similar age from Drugs & Aging
#31
of 412 outputs
Altmetric has tracked 25,373,627 research outputs across all sources so far. Compared to these this one has done well and is in the 89th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,293 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.3. This one has done well, scoring higher than 87% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 187,169 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 90% of its contemporaries.
We're also able to compare this research output to 412 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 91% of its contemporaries.