MOJ
eISSN: 2574-8130
Submit manuscript...
Review Article Volume 11 Issue 2
Benzodiazepines in the elderly: mechanisms, dependence risks and clinical implications for geriatric practice
Michel Bourin
Received: August 17, 2026 | Published: September 4, 2026
Citation: Bourin M. Benzodiazepines in the elderly: mechanisms, dependence risks, and clinical implications for geriatric practice. MOJ Gerontol Ger. 2026;11(2):43‒49. DOI: 10.15406/mojgg.2026.11.00358
Abstract
Benzodiazepines (BZDs) remain among the most frequently prescribed psychotropic medications in geriatric populations, despite decades of evidence documenting their association with cognitive decline, falls, fractures, and dependence. This review synthesizes current understanding of BZD pharmacology, the mechanisms underlying tolerance and withdrawal, and the unique vulnerabilities of older adults to BZD-related adverse outcomes. We examine the epidemiological burden of BZD use in the elderly, the evidence linking prolonged exposure to dementia risk, and the clinical challenges of deprescribing in long-term users. Attention is given to the role of half-life in dependence severity, the phenomenon of paradoxical reactions in older patients, and the parallels between BZD and alcohol dependence that remain underexplored in geriatric research. We conclude with evidence-based recommendations for judicious prescribing, monitoring, and withdrawal management tailored to the geriatric population, emphasizing the need for nonpharmacological alternatives and systematic deprescribing protocols.
Keywords: Benzodiazepines, elderly, dependence, withdrawal, cognitive impairment, falls, deprescribing, GABA receptors, polypharmacy
©2026 Bourin. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.