Benzodiazepines, Z-drugs and the risk of hip fracture: A systematic review and meta-analysis
Open accessAbstract
BACKGROUND: Hip fractures in the older person lead to an increased risk of mortality, poorer quality of life and increased morbidity. Benzodiazepine (BNZ) use is associated with increased hip fracture rate, consequently Z-drugs are fast becoming the physician's hypnotic prescription of choice yet data on their use is limited. We compared the risk of hip fracture associated with Z-drugs and BNZ medications, respectively, and examined if this risk varied with longer-term use. METHODS AND FINDINGS: We carried out a systematic review of the literature and meta-analysis. MEDLINE and SCOPUS were searched to identify studies involving BNZ or Z-drugs and the risk of hip fracture up to May 2015. Each included study was quality-assessed. A pooled relative risk of hip fracture was calculated using the generic inverse variance method, with a random effects model, with the length of hypnotic usage as a subgroup. Both BNZ, and Z-drug use respectively, were significantly associated with an increased risk of hip fracture (RR = 1.52, 95% CI 1.37-1.68; and RR = 1.90, 95% CI 1.68-2.13). Short-term use of BNZ and Z-drugs respectively, was also associated with the greatest risk of hip fracture (RR = 2.40, 95% CI 1.88-3.05 and RR = 2.39, 95% CI 1.74-3.29). CONCLUSIONS: There is strong evidence that both BNZ and Z-drugs are associated with an increased risk of hip fracture in the older person, and there is little difference between their respective risks. Patients newly prescribed these medicines are at the greatest risk of hip fracture. Clinicians and policy makers need to consider the increased risk of fallings and hip fracture particularly amongst new users of these medications.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Longer-term benzodiazepine use is associated with physical dependence, tolerance, loss of efficacy, falls, fractures, and memory disturbance.
“Longer-term use is associated with a number of physical and cognitive risks, including physical dependence, tolerance, loss of efficacy, falls, and fractures ( Donnelly et al., 2017) and memory disturbance (Lister, 1985).”
From Pharmacological principles for safe benzodiazepine and Z-drug dose reduction (2026) · cites this paper as Donnelly et al., 2017
The Introduction reports dependence and tolerance among chronic benzodiazepine users and links benzodiazepines to falls and fractures. The Discussion also describes dependence and falls as risks of long-term prescription, but our copy does not establish loss of efficacy. Memory disturbance is attributed to Lister (1985) in the citing sentence, not to Donnelly et al. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823 · see citing works
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000097 · Cited by 64,042 · see citing works
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
(2009) · PubMed Central · Cited by 44,859 · see citing works
Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series
(2008) · doi:10.1002/9780470712184 · Cited by 25,048 · see citing works
Wang, G., Ma, R., Qiao, G., Wada, K., Aizawa, Y., & Satoh, T. (2015) · Integrative Medicine International · doi:10.1159/000368408 · Cited by 18,759 · see citing works
Cochrane Handbook for Systematic Reviews of Interventions
Higgins, J. P. T., Green, S., & Ben Van Den, A. (2020) · International Coaching Psychology Review · doi:10.53841/bpsicpr.2020.15.2.123 · Cited by 5,670 · see citing works
Cochrane Handbook for Systematic Reviews of Interventions
Tarsilla, M. (2010) · Journal of MultiDisciplinary Evaluation · doi:10.56645/jmde.v6i14.284 · Cited by 5,228 · see citing works
Risk Factors for Hip Fracture in White Women
Cummings, S. R., Nevitt, M. C., Browner, W. S., Stone, K., Fox, K. M., Ensrud, K. E., Cauley, J., Black, D., & Vogt, T. M. (1995) · New England Journal of Medicine · doi:10.1056/nejm199503233321202 · Cited by 3,595 · see citing works
Chapter 9: Analysing Data and Undertaking Meta-Analyses
Deeks, J. J., Higgins, J. P. T., & Altman, D. G. (2008) · Cited by 2,782 · see citing works
Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits
Glass, J., Lanctôt, K. L., Herrmann, N., Sproule, B. A., & Busto, U. E. (2005) · BMJ · doi:10.1136/bmj.38623.768588.47 · Cited by 1,161 · see citing works
Benzodiazepine Use in the United States
Olfson, M., King, M., & Schoenbaum, M. (2015) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2014.1763 · Cited by 786 · see citing works
Leibson, C. L., Tosteson, A. N. A., Gabriel, S. E., Ransom, J. E., & Melton, L. J. (2002) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.2002.50455.x · Cited by 693 · see citing works
Benzodiazepine pharmacology and central nervous system-mediated effects.
(2013) · Europe PMC (PubMed Central) · Cited by 650 · see citing works
Central Nervous System–Active Medications and Risk for Falls in Older Women
Ensrud, K. E., BLACKWELL, T. L., Mangione, C. M., Bowman, P. J., Whooley, M. A., Bauer, D. C., Schwartz, A. V., Hanlon, J. T., & Nevitt, M. C. (2002) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.2002.50453.x · Cited by 621 · see citing works
Central Nervous System Active Medications and Risk for Fractures in Older Women
Ensrud, K. E. (2003) · Archives of Internal Medicine · doi:10.1001/archinte.163.8.949 · Cited by 278 · see citing works
Zolpidem Use and Hip Fractures in Older People
Wang, P. S., Bohn, R. L., Glynn, R. J., Mogun, H., & Avorn, J. (2001) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2001.49280.x · Cited by 272 · see citing works
SCOPE: a scorecard for osteoporosis in Europe
Kanis, J. A., Borgström, F., Compston, J., Dreinhöfer, K., Nolte, E., Jönsson, L., Lems, W. F., McCloskey, E. V., Rizzoli, R., & Stenmark, J. (2013) · Archives of Osteoporosis · doi:10.1007/s11657-013-0144-1 · Cited by 246 · see citing works
Benzodiazepine Use and Hip Fractures in the Elderly
Wagner, A. K., Zhang, F., Soumerai, S. B., Walker, A. M., Gurwitz, J. H., Glynn, R. J., & Ross‐Degnan, D. (2004) · Archives of Internal Medicine · doi:10.1001/archinte.164.14.1567 · Cited by 243 · see citing works
The clinical and forensic toxicology of Z-drugs
Gunja, N. (2013) · Journal of Medical Toxicology · doi:10.1007/s13181-013-0292-0 · Cited by 230 · see citing works
Gustavsen, I., Bramness, J. G., Skurtveit, S. O., Engeland, A., Neutel, I., & Mørland, J. G. (2008) · Sleep Medicine · doi:10.1016/j.sleep.2007.11.011 · Cited by 201 · see citing works
Medication use and risk of falls
Neutel, C. I., Perry, S., & Maxwell, C. J. (2002) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.686 · Cited by 177 · see citing works
Guo, Z., Wills, P., Viitanen, M. H., Fastbom, J., & Winblad, B. G. (1998) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009714 · Cited by 167 · see citing works
Fracture Risk From Psychotropic Medications: A Population-Based Analysis
Bolton, J. M., Metge, C., Lix, L., Prior, H., Sareen, J., & Leslie, W. D. (2008) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e31817d5943 · Cited by 158 · see citing works
Nonbenzodiazepine Sleep Medication Use and Hip Fractures in Nursing Home Residents
Berry, S. D., Lee, Y., Cai, S., & Dore, D. D. (2013) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2013.3795 · Cited by 147 · see citing works
Finkle, W. D., Der, J. S., Greenland, S., Adams, J., Ridgeway, G. K., Blaschke, T. F., Wang, Z., Dell, R. M., & VanRiper, K. B. (2011) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2011.03591.x · Cited by 141 · see citing works
Association between use of benzodiazepines and risk of fractures: a meta-analysis
Xing, D., L., X., Ma, J. X., Wang, J., Yang, Y., & Chen, Y. (2013) · Osteoporosis International · doi:10.1007/s00198-013-2446-y · Cited by 137 · see citing works
Mortality in British hip fracture patients, 2000–2010: A population-based retrospective cohort study
Klop, C., Welsing, P. M. J., Cooper, C. C., Harvey, N. C., Elders, P. J. M., Bijlsma, J. W. J., Leufkens, H. G. M., & de Vries, F. (2014) · Bone · doi:10.1016/j.bone.2014.06.011 · Cited by 134 · see citing works
Benzodiazepines and hip fractures in elderly people: case-control study
Pierfitte, C., Macouillard, G., Thicoïpe, M., Chaslerie, A., Pehourcq, F., Aïssou, M., Martinez, B., Lagnaoui, R., Fourrier, A., Bégaud, B., et al. (2001) · BMJ · doi:10.1136/bmj.322.7288.704 · Cited by 131 · see citing works
Bakken, M. S., Engeland, A., Engesaeter, L. B., Ranhoff, A. H., Hunskaar, S., & Ruths, S. (2014) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-014-1684-z · Cited by 124 · see citing works
Siriwardena, A. N., Qureshi, Z., Gibson, S., Collier, S., & Latham, M. (2006) · PubMed Central · Cited by 118 · see citing works
Huybrechts, K. F., Rothman, K. J., Silliman, R. A., Brookhart, A. M., & Schneeweiß, S. (2011) · Canadian Medical Association Journal · doi:10.1503/cmaj.101406 · Cited by 112 · see citing works
Zint, K., Haefeli, W. E., Glynn, R. J., Mogun, H., Avorn, J., & Stürmer, T. (2010) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.2031 · Cited by 108 · see citing works
Trends in potentially inappropriate prescribing amongst older UK primary care patients
Wilde, S. D., Carey, I. M., Harris, T. J., Richards, N., Victor, C. R., Hilton, S. R., & Cook, D. G. (2006) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.1306 · Cited by 106 · see citing works
Zolpidem Use and Risk of Fracture in Elderly Insomnia Patients
Kang, D. Y., Park, S., Rhee, C.-W., Kim, Y., Choi, N., Lee, J., & Park, B. (2012) · Journal of Preventive Medicine and Public Health · doi:10.3961/jpmph.2012.45.4.219 · Cited by 106 · see citing works
An Economic Evaluation of a Systems-Based Strategy to Expedite Surgical Treatment of Hip Fractures
Dy, C. J., McCollister, K. E., Lubarsky, D. A., & Lane, J. M. (2011) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.i.01132 · Cited by 102 · see citing works
Coutinho, E. S. F., FLETCHER, A. E., Bloch, K. V., & Rodrigues, L. C. (2008) · BMC Geriatrics · doi:10.1186/1471-2318-8-21 · Cited by 96 · see citing works
Misuse of benzodiazepines and Z-drugs in the UK
Kapil, V., Green, J. L., Lait, C. L., Wood, D. M., & Dargan, P. I. (2014) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.114.149252 · Cited by 92 · see citing works
Effect of hypnotic drugs on body balance and standing steadiness
Mets, M. A. J., Volkerts, E. R., Olivier, B., & Verster, J. C. (2010) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2009.10.008 · Cited by 89 · see citing works
Khong, T. P., de Vries, F., Goldenberg, J. S. B., Klungel, O. H., Robinson, N. J., Ibáñez, L., & Petri, H. (2012) · Calcified Tissue International · doi:10.1007/s00223-012-9603-8 · Cited by 87 · see citing works
Medical Care of Elderly Patients With Hip Fractures
Huddleston, J. M., & Whitford, K. J. (2001) · Mayo Clinic Proceedings · doi:10.4065/76.3.295 · Cited by 87 · see citing works
Older Adults' Medication Use 6 Months Before and After Hip Fracture: A Population‐Based Cohort Study
Kragh, A., Elmståhl, S., & Atroshi, I. (2011) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2011.03372.x · Cited by 84 · see citing works
Thorell, K., Ranstad, K., Midlöv, P., Borgqúist, L., & Halling, A. (2014) · BMC Geriatrics · doi:10.1186/1471-2318-14-131 · Cited by 82 · see citing works
Risk Factors for Hip Fractures Occurring in the Hospital
Lichtenstein, M. J., Griffin, M. R., Cornell, J. E., Malcolm, E., & Ray, W. A. (1994) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a117331 · Cited by 70 · see citing works
Benzodiazepine and Risk of Hip Fractures in Older People: A Nested Case-Control Study in Taiwan
Chang, C., Wu, E. C., Chang, I., & Lin, K. (2008) · American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e31817c6a99 · Cited by 68 · see citing works
Use of benzodiazepines and related drugs in Manitoba: a population-based study
Alessi‐Severini, S., Bolton, J. M., Enns, M. W., Dahl, M. E., Collins, D. M., Chateau, D. G., & Sareen, J. (2014) · CMAJ Open · doi:10.9778/cmajo.20130076 · Cited by 66 · see citing works
The direct cost of acute hip fracture care in care home residents in the UK
Sahota, O., Morgan, N., & Moran, C. G. (2011) · Osteoporosis International · doi:10.1007/s00198-011-1651-9 · Cited by 50 · see citing works
Zolpidem use and risk of fractures: a systematic review and meta-analysis
Park, S.-M., Ryu, J. K., Lee, D. R., Shin, D., Yun, J. M., & Lee, J. (2016) · Osteoporosis International · doi:10.1007/s00198-016-3605-8 · Cited by 49 · see citing works
Drugs and femoral neck fracture: a case‐control study
Jensen, J. G., Nielsen, L. H., Lyhne, N., Hallas, J., Brøsen, K., & Gram, L. F. (1991) · Journal of Internal Medicine · doi:10.1111/j.1365-2796.1991.tb00302.x · Cited by 33 · see citing works
Perreault, S., Dragomir, A., Blais, L., Moride, Y., Rossignol, M., Ste‐Marie, L., & Fernandes, J. (2008) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.1551 · Cited by 31 · see citing works
Golden, A. G., Ma, Q., Nair, V. P., Florez, H. J., & Roos, B. A. (2010) · Annals of Pharmacotherapy · doi:10.1345/aph.1p210 · Cited by 28 · see citing works
Hockings, N., & Ballinger, B. R. (1983) · BMJ · doi:10.1136/bmj.286.6382.1949 · Cited by 18 · see citing works
Neugebrauch von Benzodiazepinen und das Risiko einer proximalen Femurfraktur
Hoffmann, F., & Glaeske, G. (2006) · Zeitschrift für Gerontologie und Geriatrie · doi:10.1007/s00391-006-0337-y · Cited by 18 · see citing works
Smolders, M., Laurant, M., van Rijswijk, E., Mulder, J., Braspenning, J., Verhaak, P., Wensing, M., & Grol, R. (2007) · Family Practice · doi:10.1093/fampra/cmm062 · Cited by 15 · see citing works
Chan, A. L. F., & Lin, S. (2010) · International Journal of Psychiatry in Clinical Practice · doi:10.3109/13651500903434461 · Cited by 8 · see citing works
Épidémiologie et facteurs de risque des fractures de l’extrémité supérieure du fémur
Boddaert, J., Raux, M., Khiami, F., & Riou, B. (2015) · Annales françaises de médecine d’urgence · doi:10.1007/s13341-015-0525-8 · Cited by 4 · see citing works
Changes in prescribing patterns of benzodiazepines after training of general practitioners
Alves-dos-Reis, T., Papoila, A. L., & Gusmão, R. M. (2016) · European Psychiatry · doi:10.1016/j.eurpsy.2016.01.045 · Cited by 1 · see citing works
Flagged first, then by citations
2 of the 58 references couldn’t be matched to a known paper.
Research works printed but not linked: 5
- [1]Boddaert J, Raux M, Khiami F, Riou B. Hip fractures: Epidemiology and risk factors. Annales françaises de médecine d’urgence. 2015; 5(2): 119– 25.
- [39]Joint Formularly Committee. Clonazepam 2017 [cited 07 Jan 2017]. In: British National Formularly [Internet]. London: BMJ Group and Pharmaceutical Press, [cited 07 Jan 2017]. https://www.medicinescomplete.com/mc/bnf/current/PHP3010-clonazepam.htm?q=clonazepam&t=search&ss=text&tot=32&p=1-_hit.
- [40]Joint Formulary Committee. Benzodiazepines 2017 [cited 07 Jan 2017]. In: British National Formularly [Internet]. London: BMJ Group and Pharmaceutical Press, [cited 07 Jan 2017]. https://www.medicinescomplete.com/mc/bnf/current/_882653840.htm?q=benzodiazepines&t=search&ss=text&tot=29&p=17-_hit.
- [42]Reeves B, Deeks J, Higgins J, Wells G. Chapter 13: Including Non-Randomized Studies 2008 In: Cochrane Handbook for Systematic Reviews of Interventions [Internet]. The Cochrane Collaboration www.handbook.cochrane.org.
- [63]National Institute for Health and Clinical Excellence. Falls in older people: assessing risk and prevention. London: NICE; 2013. 31869045
Cited by
Sorted by citations
Insomnia in Elderly Patients: Recommendations for Pharmacological Management
Abad, V. C., & Guilleminault, C. (2018) · Drugs & Aging · doi:10.1007/s40266-018-0569-8 · Cited by 174 · see citing works
The importance of the circadian system & sleep for bone health
Swanson, C. M., Kohrt, W. M., Buxton, O. M., Everson, C. A., Wright, K. P., ORWOLL, E. S., & Shea, S. A. (2017) · Metabolism · doi:10.1016/j.metabol.2017.12.002 · Cited by 161 · see citing works
Morin, C. M., & Buysse, D. J. (2024) · New England Journal of Medicine · doi:10.1056/nejmcp2305655 · Cited by 169 · see citing works
Ng, B. J., Le Couteur, D. G., & Hilmer, S. N. (2018) · Drugs & Aging · doi:10.1007/s40266-018-0544-4 · Cited by 118 · see citing works
Hypnotic drug risks of mortality, infection, depression, and cancer: but lack of benefit
Kripke, D. F. (2016) · F1000Research · doi:10.12688/f1000research.8729.1 · Cited by 105 · see citing works
Insomnia and Other Sleep Disorders in Older Adults
Cohen, Z. L., Eigenberger, P., Sharkey, K. M., Conroy, M. L., & Wilkins, K. M. (2022) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2022.07.002 · Cited by 82 · see citing works
Richardson, K., Loke, Y. K., Fox, C., Maidment, I., Howard, R., Steel, N., Arthur, A., Boyd, P. J., Aldus, C., Ballard, C., et al. (2020) · BMC Medicine · doi:10.1186/s12916-020-01821-5 · Cited by 73 · see citing works
Polypharmacy and injurious falls in older adults: a nationwide nested case-control study
Morin, L., Calderón‐Larrañaga, A., Welmer, A., Rizzuto, D., Wastesson, J. W., & Johnell, K. (2019) · Clinical Epidemiology · doi:10.2147/clep.s201614 · Cited by 69 · see citing works
Ngcobo, N. N. (2025) · Clinical Pharmacokinetics · doi:10.1007/s40262-024-01466-0 · Cited by 95 · see citing works
Machado‐Duque, M. E., Castaño, J. P., Medina-Morales, D. A., Castro‐Rodríguez, A., González-Montoya, A., & Machado‐Alba, J. E. (2017) · International Psychogeriatrics · doi:10.1017/s1041610217002745 · Cited by 68 · see citing works
Evrard, P., Pétein, C., Beuscart, J.-B., & Spinewine, A. (2022) · Implementation Science · doi:10.1186/s13012-022-01206-7 · Cited by 62 · see citing works
Association Between Atrial Fibrillation and Dementia: A Meta-Analysis
Islam, M. M., Poly, T. N., Walther, B. A., Yang, H., Wu, C., Lin, M., Chien, S.-C., & Li, Y. (2019) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2019.00305 · Cited by 62 · see citing works
Incidence of and Characteristics Associated With Long-term Benzodiazepine Use in Finland
Taipale, H. T., Särkilä, H., Tanskanen, A. J., Kurko, T., Taiminen, T. J., Tiihonen, J., Sund, R., Tuulio‐Henriksson, A., Saastamoinen, L., & Hietala, J. A. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.19029 · Cited by 59 · see citing works
Pharmacotherapy for chronic non-specific low back pain: current and future options
Koes, B. W., Backes, D., & Bindels, P. (2018) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2018.1454430 · Cited by 59 · see citing works
Kastora, S. L., Kounidas, G., Perrott, S. L., Carter, B., Hewitt, J., & Myint, P. K. (2021) · EClinicalMedicine · doi:10.1016/j.eclinm.2021.100896 · Cited by 58 · see citing works
Self-citationBronskill, S. E., Campitelli, M. A., Iaboni, A., Herrmann, N., Guan, J., Maclagan, L. C., Watt, J., Rochon, P. A., Morris, A. M., Jeffs, L., et al. (2018) · Journal of the American Geriatrics Society · doi:10.1111/jgs.15519 · Cited by 54 · see citing works
Poly, T. N., Islam, M. M., Yang, H.-C., & Li, Y.-C. (. (2020) · Joint Bone Spine · doi:10.1016/j.jbspin.2019.11.003 · Cited by 53 · see citing works
Tseng, L.-Y., Huang, S., Peng, L., Chen, L., & Hsiao, F. (2019) · Neurotherapeutics · doi:10.1007/s13311-019-00801-9 · Cited by 54 · see citing works
Takano, A., Ono, S., Yamana, H., Matsui, H., Matsumoto, T., Yasunaga, H., & Kawakami, N. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-029641 · Cited by 49 · see citing works
Sedative Hypnotics and the Risk of Falls and Fractures in the Elderly
Andrade, C. (2018) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.18f12340 · Cited by 43 · see citing works
Sleep Disruption and Bone Health
Swanson, C. M. (2022) · Current Osteoporosis Reports · doi:10.1007/s11914-022-00733-y · Cited by 40 · see citing works
Benzodiazepine Use and Deprescribing in Belgian Nursing Homes: Results from the COME‐ON Study
Evrard, P., Henrard, S., Foulon, V., & Spinewine, A. (2020) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16751 · Cited by 38 · see citing works
Gray, S. L., Marcum, Z. A., Dublin, S., Walker, R. L., Golchin, N., Rosenberg, D. E., Bowles, E. J. A., Crane, P. K., & Larson, E. B. (2019) · The Journals of Gerontology Series A · doi:10.1093/gerona/glz270 · Cited by 35 · see citing works
Tian, F., Li, H., Chen, Z., & Xu, T. (2021) · International Journal of Clinical Practice · doi:10.1111/ijcp.14348 · Cited by 38 · see citing works
Shaw, J. C., Murphy, A. L., Turner, J. P., Gardner, D. M., Silvius, J. L., Bouck, Z., Gordon, D., & Tannenbaum, C. (2019) · Healthcare policy · doi:10.12927/hcpol.2019.25857 · Cited by 34 · see citing works
Psychotropic Drug-Associated Pneumonia in Older Adults
Rajamaki, B., Hartikainen, S. A., & Tolppanen, A. (2020) · Drugs & Aging · doi:10.1007/s40266-020-00754-1 · Cited by 34 · see citing works
Højlund, M., Gudmundsson, L. S., Andersen, J. H., Saastamoinen, L., Zoëga, H., Skurtveit, S. O., Wastesson, J. W., Hallas, J., & Pottegård, A. (2022) · Basic & Clinical Pharmacology & Toxicology · doi:10.1111/bcpt.13811 · Cited by 33 · see citing works
Okuda, S., Qureshi, Z. P., Yanagida, Y., Ito, C., Homma, Y., & Tokita, S. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04683-2 · Cited by 33 · see citing works
Gronich, N. (2024) · Drugs & Aging · doi:10.1007/s40266-024-01117-w · Cited by 32 · see citing works
Benzodiazepine and opioid co-usage in the US population, 1999–2014: an exploratory analysis
Vozoris, N. T. (2019) · SLEEP · doi:10.1093/sleep/zsy264 · Cited by 32 · see citing works
Benzodiazepines in complex biological matrices: Recent updates on pretreatment and detection methods
Zhang, Y.-X., Zhang, Y., Bian, Y., Liu, Y., Ai, R., Zhou, Y., Shi, D., & Feng, X. (2023) · Journal of Pharmaceutical Analysis · doi:10.1016/j.jpha.2023.03.007 · Cited by 31 · see citing works
Insomnia, Benzodiazepine Use, and Falls among Residents in Long-term Care Facilities
Jiang, Y., Xia, Q., Wang, J., Zhou, P., Jiang, S., Diwan, V. K., & Xu, B. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16234623 · Cited by 30 · see citing works
Mathieu, C., Joly, P., Jacqmin‐Gadda, H., Wanneveich, M., Bégaud, B., & Pariente, A. (2020) · Drug Safety · doi:10.1007/s40264-020-00992-7 · Cited by 29 · see citing works
Orthostatic hypertension and major adverse events: a systematic review and meta-analysis
Pasdar, Z., Paola, L. D., Carter, B., Pana, T. A., Potter, J. F., & Myint, P. K. (2023) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwad158 · Cited by 29 · see citing works
Self-citationAssociation of Receiving Multiple, Concurrent Fracture-Associated Drugs With Hip Fracture Risk
Emeny, R. T., Chang, C., Skinner, J., O’Malley, A. J., Smith, J., Chakraborti, G., Rosen, C. J., & Morden, N. E. (2019) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.15348 · Cited by 30 · see citing works
Hypnotic drug risks of mortality, infection, depression, and cancer: but lack of benefit
Kripke, D. F. (2018) · F1000Research · doi:10.12688/f1000research.8729.3 · Cited by 28 · see citing works
Barriers to Deprescribing Benzodiazepines in Older Adults in a Survey of European Physicians
Shapoval, V., Hubert, M. D. S., Evrard, P., Sibille, F., Aubert, C. E., Bolt, L., Tsoutsi, V., Κollia, P., Salvà, A., Miralles, R., et al. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.59883 · Cited by 26 · see citing works
Pétein, C., Spinewine, A., & Henrard, S. (2021) · Therapeutic Advances in Psychopharmacology · doi:10.1177/20451253211011874 · Cited by 25 · see citing works
Parhizkar, S., Bao, X., Chen, W., Rensing, N. R., Chen, Y., Kipnis, M., Song, S., Gent, G., Tycksen, E., Manis, M., et al. (2025) · Nature Neuroscience · doi:10.1038/s41593-025-01966-7 · Cited by 27 · see citing works
Gentle rocking movements during sleep in the elderly
van Sluijs, R., Wilhelm, E., Rondei, Q. J., Omlin, X., Crivelli, F., Straumann, D., Jaeger, L., Riener, R., & Achermann, P. (2020) · Journal of Sleep Research · doi:10.1111/jsr.12989 · Cited by 24 · see citing works
Role of nurses in supporting proactive deprescribing
Wright, D. J., Scott, S., Buck, J., & Bhattacharya, D. (2019) · Nursing Standard · doi:10.7748/ns.2019.e11249 · Cited by 24 · see citing works
Sleep disruptions and bone health: what do we know so far?
Swanson, C. M. (2021) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0000000000000639 · Cited by 23 · see citing works
Moriarty, F., Thompson, W., & Boland, F. (2021) · Research in Social and Administrative Pharmacy · doi:10.1016/j.sapharm.2021.05.007 · Cited by 21 · see citing works
Tikhonova, T. A., Rassokhina, I. V., Kondrakhin, E. A., Fedosov, M. A., Bukanova, J. V., Rossokhin, A. V., Sharonova, I. N., Kovalev, G. I., Zavarzin, I. V., & Volkova, Y. A. (2019) · Bioorganic Chemistry · doi:10.1016/j.bioorg.2019.103334 · Cited by 21 · see citing works
Jansana, A., Poblador‐Plou, B., Miguel, A. G., Lanzuela, M., Prados‐Torres, A., Domingo, L., Comas, M., Sanz‐Cuesta, T., del Cura-González, I., Ibáñez, B., et al. (2021) · International Journal of Cancer · doi:10.1002/ijc.33736 · Cited by 21 · see citing works
Oliva, V., Fanelli, G., Zamparini, M., Zarbo, C., Rocchetti, M., Casiraghi, L., Starace, F., Martinelli, A., Serretti, A., & de Girolamo, G. (2022) · International Clinical Psychopharmacology · doi:10.1097/yic.0000000000000433 · Cited by 20 · see citing works
Richardson, K., Savva, G. M., Boyd, P. J., Aldus, C. F., Maidment, I. D., Pakpahan, E., Loke, Y. K., Arthur, A. J., Steel, N., Ballard, C. G., et al. (2021) · Health Technology Assessment · doi:10.3310/hta25010 · Cited by 21 · see citing works
Zeraatkar, D., Nagraj, S. K., Ling, M., Jassal, T., Kirsh, S., Lima, J. P., Pitre, T., Couban, R., Hussain, M., Seterelv, S. S., et al. (2025) · BMJ · doi:10.1136/bmj-2024-081336 · Cited by 22 · see citing works
Keenan, R. J., Daykin, H. J., Metha, J. A., Cornthwaite‐Duncan, L., Wright, D. K., Clarke, K. M., Oberrauch, S., Brian, M. L., Stephenson, S. E. M., Nowell, C. J., et al. (2023) · British Journal of Pharmacology · doi:10.1111/bph.16212 · Cited by 18 · see citing works
Helicobacter pylori Related Diseases and Osteoporotic Fractures (Narrative Review)
Fisher, L., Fisher, A., & Smith, P. N. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9103253 · Cited by 18 · see citing works
1,4-Benzodiazepines and New Derivatives: Description, Analysis, and Organic Synthesis
Batlle, E., Lizano, E., Viñas, M., & Pujol, M. D. (2019) · IntechOpen eBooks · doi:10.5772/intechopen.79879 · Cited by 19 · see citing works
Assimon, M. M., & Flythe, J. E. (2020) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.10070620 · Cited by 18 · see citing works
Hip, vertebral, and wrist fracture risks and schizophrenia: a nationwide longitudinal study
Chu, Y.-W., Chen, W., Yang, A. C., Tsai, S., Hu, L., Lee, S.-C., Lee, Y., & Shen, C. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-03723-7 · Cited by 16 · see citing works
Soumerai, S. B., Shahzad, M., & Salzman, C. (2024) · American Journal of Psychiatry · doi:10.1176/appi.ajp.20240030 · Cited by 16 · see citing works
Vicens, C., Leiva, A., Bejarano, F., Sempere-Verdú, E., Rodríguez-Rincón, R. M., Fiol, F., Mengual, M., Ajenjo-Navarro, A., Do Pazo, F., Mateu, C., et al. (2022) · PLOS Medicine · doi:10.1371/journal.pmed.1003983 · Cited by 15 · see citing works
Rozing, M. P., Wium‐Andersen, M. K., Wium‐Andersen, I. K., Jørgensen, T. S. H., Jørgensen, M. B., & Osler, M. (2023) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.13610 · Cited by 15 · see citing works
Joza, S., Camicioli, R. M., & Ba, F. (2019) · Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · doi:10.1017/cjn.2019.287 · Cited by 15 · see citing works
Hill, S. L., & Thomas, S. H. L. (2016) · Medicine · doi:10.1016/j.mpmed.2015.12.030 · Cited by 15 · see citing works
Benzodiazepine Treatment and Fracture Risk in Young Persons With Anxiety Disorders
Bushnell, G., Gerhard, T., Crystal, S., & Olfson, M. (2020) · PEDIATRICS · doi:10.1542/peds.2019-3478 · Cited by 15 · see citing works
Insomnia in primary care: Considerations for screening, assessment, and management
Yamamoto, M., Lim, C. T., Huang, H., Spottswood, M., & Huang, H. Y. (2023) · The Journal of Medicine Access · doi:10.1177/27550834231156727 · Cited by 15 · see citing works
Isomura, K., Wang, X., Chang, Z., Hellner, C., Hasselström, J., Ekheden, I. G., Jayaram‐Lindström, N., Lichtenstein, P., D'Onofrio, B. M., Mataix‐Cols, D., et al. (2023) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-023-03515-2 · Cited by 15 · see citing works
Uragami, M., Matsushita, K., Shibata, Y., Takata, S., Karasugi, T., Sueyoshi, T., Masuda, T., Nakamura, T., Tokunaga, T., Hisanaga, S., et al. (2023) · Bone · doi:10.1016/j.bone.2023.116865 · Cited by 13 · see citing works
Keck, M. E., Nicolussi, S., Spura, K., Blohm, C., Zahner, C., & Drewe, J. (2020) · Phytotherapy Research · doi:10.1002/ptr.6618 · Cited by 12 · see citing works
van de Ven, L. I., Klop, C., Overbeek, J. A., de Vries, F., Burden, A. M., & Janssen, P. K. C. (2018) · Osteoporosis International · doi:10.1007/s00198-018-4632-4 · Cited by 13 · see citing works
Holmerová, I., Auer, S., Beránková, A., Höfler, M., Ratajczak, P., & Šteffl, M. (2018) · Clinical Interventions in Aging · doi:10.2147/cia.s188601 · Cited by 13 · see citing works
Takeuchi, Y., Sano, H., Asai, Y., Miyazaki, M., Iwakura, M., & Maeda, Y. (2019) · Current Medical Research and Opinion · doi:10.1080/03007995.2019.1700361 · Cited by 13 · see citing works
Xu, C., Leung, J. C. N., Shi, J., Lum, D. H., & Lai, F. T. T. (2023) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2023.101866 · Cited by 12 · see citing works
BPSD Patterns in Patients With Severe Neuropsychiatric Disturbances: Insight From the RECAGE Study
Cognat, E., Sabia, S., Fayel, A., Lilamand, M., Handels, R. L. H., Fascendini, S., Bergh, S., Frisoni, G. B., Fabbo, A., Tsolaki, M., et al. (2023) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2023.03.014 · Cited by 12 · see citing works
Kim, C. H., Lee, Y.-J., Kang, S., & Lee, S. H. (2025) · Journal of Medical Internet Research · doi:10.2196/67751 · Cited by 12 · see citing works
Yoshioka, R., Yamamoto, S., & Nakatani, E. (2023) · PLoS ONE · doi:10.1371/journal.pone.0284726 · Cited by 11 · see citing works
Tevik, K., Selbæk, G., Engedal, K., Seim, A., Krokstad, S., & Helvik, A. (2019) · PLoS ONE · doi:10.1371/journal.pone.0214813 · Cited by 11 · see citing works
Chukwulebe, S. B., Kim, H. S., McCarthy, D. M., Courtney, D. M., Lank, P. M., Gravenor, S. J., & Dresden, S. M. (2019) · Journal of the American Geriatrics Society · doi:10.1111/jgs.15722 · Cited by 11 · see citing works
Case–control study examining the association between hip fracture and zaleplon use in older adults
Lai, S., Chang-Ou, K.-C., Lin, C., & Liao, K. (2019) · Postgraduate Medical Journal · doi:10.1136/postgradmedj-2019-136467 · Cited by 10 · see citing works
Evrard, P., Damiaens, A., Patey, A. M., Grimshaw, J., & Spinewine, A. (2023) · Exploratory Research in Clinical and Social Pharmacy · doi:10.1016/j.rcsop.2023.100258 · Cited by 10 · see citing works
Bell, J. S., Caze, A. L., Steeper, M., Haines, T. P., Hilmer, S. N., Troeung, L., Quirke, L., Wesson, J., Pond, C. D., Buys, L. R., et al. (2024) · Implementation Science · doi:10.1186/s13012-024-01353-z · Cited by 10 · see citing works
Depression and the Risk of Fractures in Later Life: the Health In Men Cohort Study
Almeida, O. P., Hankey, G. J., Golledge, J., Yeap, B. B., & Flicker, L. A. (2020) · Maturitas · doi:10.1016/j.maturitas.2020.12.004 · Cited by 10 · see citing works
Beetz, G., Babiloni, A. H., Jodoin, M., Charlebois‐Plante, C., Lavigne, G. J., Beaumont, L. D., & Rouleau, D. M. (2021) · PubMed · doi:10.2106/jbjs.21.00176 · Cited by 9 · see citing works
Le, T. M., Campbell, S., Andraos, A., Ahlmark, P., Hoang, H., Isserman, S. L., Goldzweig, C. L., Mays, A. M., Bradley, K., & Keller, M. S. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-080109 · Cited by 9 · see citing works
Impact of Chinese criteria on potentially inappropriate medication use in China
Tian, F., Chen, Z., Zhang, Y., Feng, Q., & Chen, X. (2025) · Journal of Global Health · doi:10.7189/jogh.15.04063 · Cited by 9 · see citing works
Hypnotic Discontinuation Using a Blinded (Masked) Tapering Approach: A Case Series
Fung, C. H., Martin, J. L., Alessi, C., Dzierzewski, J. M., Cook, I. A., Moore, A. A., Grinberg, A. M., Zeidler, M. R., & Kierlin, L. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00717 · Cited by 9 · see citing works
Adomi, M., Maeda, M., Murata, F., & Fukuda, H. (2022) · Journal of the American Geriatrics Society · doi:10.1111/jgs.18068 · Cited by 9 · see citing works
Benzodiazepine Use and Falls in Older Adults: Is It Worth the Risk?
McDonald, E. M., & Caslangen, J. (2019) · Research in Gerontological Nursing · doi:10.3928/19404921-20190813-01 · Cited by 9 · see citing works
Guo, M., Tao, S., Xiong, Y., Dong, M., Yan, Z., Ye, Z., & Wu, D. (2024) · Psychiatry Research · doi:10.1016/j.psychres.2024.115974 · Cited by 9 · see citing works
Ogawa, Y., Hirai, T., & Mihara, K. (2021) · Journal of Pharmaceutical Health Care and Sciences · doi:10.1186/s40780-021-00213-y · Cited by 8 · see citing works
Tsuboi, T., Takaesu, Y., Hasegawa, N., Ochi, S., Fukumoto, K., Ohi, K., Muraoka, H., Okada, T., Kodaka, F., Igarashi, S., et al. (2022) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.13489 · Cited by 8 · see citing works
Sessa, M., Mascolo, A., Dalhoff, K., & Andersen, M. T. (2020) · Expert Opinion on Drug Safety · doi:10.1080/14740338.2020.1711882 · Cited by 8 · see citing works
Care coordination needs for deprescribing benzodiazepines and benzodiazepine receptor agonists
McCarthy, M. S., Mak, S., Kaufmann, C. N., Lum, H. D., & Fung, C. H. (2021) · Research in Social and Administrative Pharmacy · doi:10.1016/j.sapharm.2021.06.025 · Cited by 8 · see citing works
Pétein, C., Spinewine, A., Laroche, M., Niquille, A., & Henrard, S. (2023) · Research in Social and Administrative Pharmacy · doi:10.1016/j.sapharm.2023.05.010 · Cited by 7 · see citing works
Fi, B., Sumin, A. N., Garganeeva, N. P., Ларева, Н. В., Петрова, М. М., Петрунько, О. В., Попонина, Т. М., Repin, A. N., & Собенников, В. С. (2024) · Complex Issues of Cardiovascular Diseases · doi:10.17802/2306-1278-2024-13-3s-222-253 · Cited by 7 · see citing works
Ohara, E., Bando, Y., Yoshida, T., Ohara, M., Kirino, Y., & Iihara, N. (2020) · Biological and Pharmaceutical Bulletin · doi:10.1248/bpb.b19-00737 · Cited by 7 · see citing works
Association of lower urinary tract symptoms and hip fracture in adults aged ≥ 50 years
Liu, P.-S., Huang, H., & Ding, D. (2021) · PLoS ONE · doi:10.1371/journal.pone.0246653 · Cited by 7 · see citing works
Hwang, S., Son, H., Kim, M., Lee, S. K., & Jung, K. (2022) · Journal of Clinical Neurology · doi:10.3988/jcn.2022.18.1.65 · Cited by 7 · see citing works
Chen, C., Hennessy, S., Brensinger, C. M., Acton, E. K., Bilker, W. B., Chung, S. P., Dawwas, G. K., Horn, J. R., Miano, T. A., Nguyen, T. P. P., et al. (2022) · Scientific Reports · doi:10.1038/s41598-022-19551-4 · Cited by 7 · see citing works
Efficacy and Safety of Naproxen for Acute Pain
Weisman, S. R. (2020) · The Journal of Family Practice · doi:10.12788/jfp.0064 · Cited by 8 · see citing works
Loosen, S. H., Killer, A., Bock, H. H., Luedde, T., Roderburg, C., & Kostev, K. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13206152 · Cited by 6 · see citing works
Mansi, E. T., Rentsch, C. T., Bourne, R. S., Guthrie, B., & Lone, N. (2024) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.70056 · Cited by 6 · see citing works
Unger, C., & Kohlmeier, K. A. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.108743 · Cited by 7 · see citing works
Mansi, E. T., Rentsch, C. T., Bourne, R. S., Jeffery, A., Guthrie, B., & Lone, N. (2025) · Intensive Care Medicine · doi:10.1007/s00134-024-07762-4 · Cited by 6 · see citing works
Managing the Burden of Dementia-Related Delusions and Hallucinations
Small (2020) · The Journal of Family Practice · doi:10.12788/jfp.0065 · Cited by 6 · see citing works
Kang, Y.-J., Lee, M., Kim, M.-S., You, S., Lee, J.-E., Eom, J.-H., & Jung, S. (2021) · Drugs & Aging · doi:10.1007/s40266-021-00872-4 · Cited by 7 · see citing works
- Authors
- Donnelly, K., Bracchi, R., Hewitt, J., Routledge, P. A., & Carter, B.
- Affiliations
- University Hospital Llandough (GB)
- Cardiff University (GB)
- University of Nottingham (GB)
- Corresponding author
- Carter, Ben
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2017-04-27
- Volume
- 12
- Issue
- 4
- Pages
- e0174730
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC5407557
- OpenAlex
- W2600488841
- Cited by
- 225
- References
- 58
- Citations by year
- 2026: 19 · 2025: 35 · 2024: 24 · 2023: 23 · 2022: 27 · 2021: 24 · 2020: 35 · 2019: 21 · 2018: 11 · 2017: 4 · 2016: 2
- FWCI
- 2.22
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Funders
- South London and Maudsley NHS Foundation Trust
- National Institute for Health and Care Research
- King's College London
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Surgery › Hip and Femur Fractures
- Keywords
- benzodiazepines, Z-drugs, hip fracture, older adults, hypnotics, fall risk, drug safety, duration of drug use, adverse drug reactions
- MeSH terms
- Zolpidem, Benzodiazepines, Hip Fractures, Humans, Pyridines
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
