Social support and sleep quality in older benzodiazepine users.

Objective: Benzodiazepines (BZD) are often prescribed to address sleep difficulties but many BZD users report a poor quality of sleep. Although social support was found to be associated with quality of sleep in a recent meta-analysis, this relationship was never studied in older BZD users. This study thus aims to examine how social support is associated with quality of sleep in older BZD users.Method: Seventy-two older adults (age 60-85) using BZD were recruited. Data was collected during the pre-test of the ''PASSE-60+; Support program for a successful withdrawal, NCT02281175'' study. Quality of sleep was measured using the Pittsburgh Sleep Quality Index (PSQI), while social support was evaluated with the Social Support Questionnaire (SSQ-6).Results: When examining the various dimensions of self-reported sleep quality as a whole, we found no significant association with social support, while controlling for daily BZD dose, anxiety and depression. However, we found a significant association between self-reported diurnal dysfunctions (e.g., daytime sleepiness) and satisfaction with social support.Conclusion: Although the results of our study should be replicated with larger samples, they might indicate that social support is not a significant factor influencing sleep quality in older chronic BZD users. Our results could differ from those found in other populations because of the changes in sleep quality associated with long term BZD use. Longitudinal studies should analyse the relationship between diurnal dysfunctions and satisfaction with social support, to examine if social support could help older adults alleviate their diurnal dysfunctions and eventually facilitate BZD tapering.

The Association between Generalized Anxiety Disorder, Subthreshold Anxiety Symptoms and Fear of Falling among Older Adults: Preliminary Results from a Pilot Study.

OBJECTIVE: A relationship between generalized anxiety disorder (GAD) and fear of falling (FOF) has long been proposed but never specifically studied. This study aimed at analyzing the relationship between FOF and GAD or anxiety symptoms, while controlling for major depressive episodes (MDE), depressive symptoms, fall risk, and sociodemographic variables. METHODS: Twenty-five older adults participated in this pilot study. Assessments included the following: Anxiety Disorder Interview Schedule, Geriatric Anxiety Inventory, Geriatric Depression Scale, Falls-Efficacy Scale-International. A multidisciplinary team evaluated fall risk. RESULTS: FOF was significantly correlated with GAD, MDE, anxiety and depressive symptoms, and fall risk, but not with sociodemographic variables. Multiple regression analyses indicated that GAD and anxiety symptoms were significantly and independently associated with FOF. CONCLUSION: Although the results of this pilot study should be replicated with larger samples, they suggest that FOF is associated with GAD and anxiety symptoms even when considering physical factors that increase the risk of falling. CLINICAL IMPLICATIONS: Treatment of FOF in patients with GAD may present a particular challenge because of the central role of intolerance of uncertainty, which may prevent patients from regaining confidence despite the reduction of fall risk. Clinicians should screen for GAD and anxiety symptoms in patients with FOF to improve detection and treatment.

The association between fear of falling and motor imagery abilities in older community-dwelling individuals.

We investigated the association between fear of falling (FoF) and motor imagery (MI) abilities in older people. Cross-sectional data from 3552 French older adults were used to conduct a multiple linear regression analysis looking at the association between FoF and MI abilities after controlling for several factors (e.g. gender, age, history of falls). MI abilities were significantly lower in older adults reporting a FoF compared with those without this fear. The presence of lower MI abilities, reflecting deficits in gait control, may explain why older people with a FoF are at higher risk of falling.