Contexte : La consommation de benzodiazépines est une pratique courante chez les personnes aînées. Cette consommation peut entraîner un problème de dépendance dont les critères du Manuel diagnostic et statistique des troubles mentaux, 4e édition révisée (DSM-IV-TR) ne s’appliqueraient pas toujours à la situation de l’aîné. Cette recherche vise à examiner l’association entre le sentiment de dépendance aux benzodiazépines et l’utilisation des services de santé par les aînés. Un objectif secondaire consiste à décrire l’utilisation des benzodiazépines chez les aînés vivant dans la communauté.

Méthode : Les données proviennent d’une enquête menée au Québec en 2005-2006 auprès d’un échantillon représentatif de 707 francophones âgés de 65 ans et plus vivant dans la communauté. Le sentiment de dépendance aux benzodiazépines a été évalué par une variable composite intégrant deux questions inspirées du DSM-IV-TR. L’utilisation des services de santé a été mesurée par l’incidence cumulée des consultations auprès des professionnels de la santé au cours d’une période de 12 mois.

Résultats : Les aînés ont consommé au total 745 benzodiazépines parmi lesquelles 117 (16,5 %) avaient une longue demi-vie d’élimination. La proportion d’aînés qui ont rapporté un sentiment de dépendance aux benzodiazépines a été estimée à 35,1 %. Ces aînés n’ont pas significativement davantage utilisé les services de santé pour leurs problèmes de dépendance aux benzodiazépines.

Conclusion : Les résultats de cette étude suggèrent que l’utilisation des benzodiazépines chez les aînés au Québec est loin d’être optimale. Par ailleurs, le besoin ressenti de dépendance ne constitue pas un facteur suffisant pour amener les aînés à utiliser les services de santé pour la prise en charge d’un problème de dépendance. Il existe donc un besoin de recherche afin de mieux cerner les barrières associées à l’utilisation des services de santé par les aînés dépendants aux benzodiazépines.

The purpose of the study was to identify the determinants of satisfaction with health care for Canadian community-dwelling older adults. A correlational design was used to examine the relationships between socio-demographic indicators, psychosocial variables, health services utilization, and satisfaction with health care in the young-old and old-old. A subsample (N = 2,413) from the 1994/95 National Population Health Survey Supplement was analysed. Hierarchical regression analyses revealed that socio-demographic variables were the best predictors of satisfaction with the national health care system in the young-old. Consultation with health care professionals was the best predictor of satisfaction with the Canadian health care system in the old-old and of health care personally received in both cohorts. Consultations with alternative practitioners was negatively related to satisfaction with health care in Canada and to care personally received in the old-old. The identification of the best determinants of satisfaction with health care can provide useful direction to policy makers, program planners, and practitioners so that more appropriate and effective services can be made available to this population.

We describe the age-specific outcomes for patients hospitalized with newly diagnosed congestive heart failure using administrative hospital abstracts from Alberta, Canada, from April 1, 1994, to March 31, 2000. Seniors (aged 65 years and older) constituted about 85 per cent of the 16,162 patients. Both co-morbidity and severity of illness tended to increase with age. The use of special care unit admissions, coronary artery diagnostic services (cardiac catheterization), and revascularization procedures (percutanenous transluminal coronary angioplasty/stenting, coronary artery bypass surgery) peaked in the 50-to 64-year age group and decreased with increasing age. Specialist/sub-specialist care, prescriptions of beta blockers and angiotensin-converting enzyme inhibitors / angiotensin receptor blockers decreased with age in seniors. Adjusted in-hospital, 1-year mortality and crude, age-specific 5-year mortality were significantly greater in those 75 years and older. Outcomes and process of care in patients with newly diagnosed congestive heart failure were not uniformly distributed with age. The elderly had greater mortality but received less therapy.

To document the use of health services for psychological distress symptoms, we collected data from a cross-section of adults aged 65 years and over. Nearly 13 per cent met DSM-IV criteria for mood or anxiety disorders. In addition, 42.4 per cent of those having at least one DSM-IV diagnosis reported having used health services. Results show a direct association between the presence of a probable DSM-IV diagnosis and health service use. However, our results show no significant association between gender and health service use, and do not support the hypothesis that minimal social support increases the probability of older adults using health services for psychological distress. The analysis suggests unmarried elders are more likely than married elders to use health services. Furthermore, this study shows that older adults having a high level of daily hassles reported using health services for psychological distress than those reporting a low stress level. We conclude that a large proportion of elderly mental health needs in Quebec are potentially not being met.