Cognitive and balance dysfunctions due to the use of zolpidem in the elderly: a systematic review

Tavares, Guilherme; Kelmann, Gizela; Tustumi, Francisco; Tundisi, Catherine Nardini; Silveira, Bárbara Regina Bruço; Barbosa, Bruno Maximiliano Augusto Colombo; Winther, Diana Bragança; Boutros, Eduarda Conte; Villar, Gabriel dos Santos; Brunocilla, Giovanna; Lourenção, Gustavo Rodrigues Caldas; Ferreira, Jiulia Giovanna Aranha; Bernardo, Wanderley Marques

doi:10.1590/1980-57642021dn15-030013

Guilherme Tavares

Department of Evidence-Based Medicine, Centro Universitário Lusíada – Santos, SP, Brazil.

https://orcid.org/0000-0001-6208-3743

Gizela Kelmann

Department of Evidence-Based Medicine, Centro Universitário Lusíada – Santos, SP, Brazil.

https://orcid.org/0000-0002-7783-9651

Francisco Tustumi

Department of Evidence-Based Medicine, Centro Universitário Lusíada – Santos, SP, Brazil.

Department of Evidence-Based Medicine, Universidade de São Paulo – São Paulo, SP, Brazil.

Department of Surgery, Hospital Israelita Albert Einstein – São Paulo, SP, Brazil.

https://orcid.org/0000-0001-6695-0496

Catherine Nardini Tundisi

Department of Evidence-Based Medicine, Centro Universitário Lusíada – Santos, SP, Brazil.

https://orcid.org/0000-0002-9732-2713

Bárbara Regina Bruço Silveira

Department of Evidence-Based Medicine, Centro Universitário Lusíada – Santos, SP, Brazil.

https://orcid.org/0000-0002-7518-2895

Bruno Maximiliano Augusto Colombo Barbosa

Department of Evidence-Based Medicine, Centro Universitário Lusíada – Santos, SP, Brazil.

https://orcid.org/0000-0001-7344-2377

Diana Bragança Winther

Department of Evidence-Based Medicine, Centro Universitário Lusíada – Santos, SP, Brazil.

https://orcid.org/0000-0001-5314-8074

Eduarda Conte Boutros

Department of Evidence-Based Medicine, Centro Universitário Lusíada – Santos, SP, Brazil.

https://orcid.org/0000-0002-5946-9087

Gabriel dos Santos Villar

Department of Evidence-Based Medicine, Centro Universitário Lusíada – Santos, SP, Brazil.

https://orcid.org/0000-0002-4726-0278

Giovanna Brunocilla

Department of Evidence-Based Medicine, Centro Universitário Lusíada – Santos, SP, Brazil.

https://orcid.org/0000-0003-2025-3737

Gustavo Rodrigues Caldas Lourenção

Department of Evidence-Based Medicine, Centro Universitário Lusíada – Santos, SP, Brazil.

https://orcid.org/0000-0002-0010-6564

Jiulia Giovanna Aranha Ferreira

Department of Evidence-Based Medicine, Centro Universitário Lusíada – Santos, SP, Brazil.

https://orcid.org/0000-0002-2627-8604

Wanderley Marques Bernardo

Department of Evidence-Based Medicine, Centro Universitário Lusíada – Santos, SP, Brazil.

Department of Evidence-Based Medicine, Universidade de São Paulo – São Paulo, SP, Brazil.

https://orcid.org/0000-0002-8597-5207

Guilherme Tavares. Rua Carolino Rodrigues, 17 – Boqueirão – 11055-070 Santos SP – Brazil. E-mail: tavaresguilherme18@gmail.com

Disclosure: The authors report no conflicts of interest.

Authors’ contributions. GT: methodology, data curation, software, validation, formal analysis, investigation, writing (original draft), writing (review and editing), visualization, and project administration. GK: conceptualization, methodology, supervision, and project administration. FT: validation, data curation, formal analysis, investigation, writing (original draft), writing (review and editing), visualization, supervision, and project administration. CNT: methodology, writing (original draft), and writing (review and editing). BRBS: methodology and writing (original draft). BMACB, DBW, ECB, GSV, GB, GRCL, and JGAF: methodology. WMB: project administration.

Author and year of publication	Study design	Patients	Intervention	Control	Outcomes analyzed	Follow-up
Uemura et al., 2015¹³13. Uemura S, Kanbayashi T, Wakasa M, Satake M, Ito W, Shimizu K, et al. Residual effects of zolpidem, triazolam, rilmazafone and placebo in healthy elderly subjects: a randomized double-blind study. Sleep Med. 2015;16(11):1395-402. https://doi.org/10.1016/j.sleep.2015.05.021 https://doi.org/https://doi.org/10.1016/...	Randomized controlled trial (RCT)/crossover	n=13 (2M and 11F) between 60 and 70 years, healthy, time to bed between 20 and 24 h.	Zolpidem (5 mg), Triazolam (0.125 mg), Rilmazafone (1 mg) — administered at bedtime — with 6 days of washout between treatments	Placebo — administered at bedtime — with 6 days of washout between treatments	CFF, SDR, SMT, body sway test, TUG and FRT	Outcomes analysis on the day after exposure, 6 days of washout — 4 periods
Boyle et al., 2009¹⁴14. Boyle J, Danjou P, Alexander R, Calder N, Gargano C, Agrawal N, et al. Tolerability, pharmacokinetics and night-time effects on postural sway and critical flicker fusion of gaboxadol and zolpidem in elderly subjects. Br J Clin Pharmacol. 2009;67(2):180-90. https://doi.org/10.1111/j.1365-2125.2008.03331.x https://doi.org/https://doi.org/10.1111/...	RCT/crossover	n=24 (7M and 17F), between 65 and 75 years, healthy, time to bed between 20 and 24 h.	Gaboxadol — 10 mg (n=24) and Zolpidem — 5 mg (n=23) — administered at bedtime — with 3 days of washout between treatments	Placebo (n=23) — administered at bedtime — with 3 days of washout between treatments	CFF, body sway test, and adverse events	Outcome analysis up to 12 h post exposure; 3 days of washout between treatment — 3 periods
Zammit et al., 2008¹⁵15. Zammit G, Wang-Weigand S, Peng X. Use of computerized dynamic posturography to assess balance in older adults after nighttime awakenings using zolpidem as a reference. BMC Geriatr. 2008;8(1):15. https://doi.org/10.1186/1471-2318-8-15 https://doi.org/https://doi.org/10.1186/...	RCT/crossover	n=11 (3M and 8F), between 65 and 81 years, healthy.	Zolpidem (10 mg) — n=11	Placebo — n=10	SOT and adverse events	Each treatment lasted 2 days, with a washout period of 2 days.
Hindmarch et al., 2006¹⁶16. Hindmarch I, Legangneux E, Stanley N, Emegbo S, Dawson J. A double-blind, placebo-controlled investigation of the residual psychomotor and cognitive effects of zolpidem-MR in healthy elderly volunteers. Br J Cli Pharmacol. 2006;62(5):538-45. https://doi.org/10.1111/j.1365-2125.2006.02705.x https://doi.org/https://doi.org/10.1111/...	RCT/crossover	n=24 (10M and 14F), between 65 and 78 years	Zolpidem (6.25 mg) — n=23, Zolpidem (12.5 mg) — n=24 and Flurazepam (30 mg) — n=23	Placebo — n=23	CFF, CRT, CTT, DSST, memory recall, and adverse events	Each treatment lasted 2 days, with a washout period of 28–42 days. After 7–14 days post exposure, there was a medical evaluation.
Bentué-Ferrer et al., 2003¹⁷17. Bentué-Ferrer D, Allain H, Tarral A, Gandon J. Effects on postural oscillation and memory functions of a single dose of zolpidem 5 mg, zopiclone 3.75 mg and lormetazepam 1 mg in elderly healthy subjects. A randomized, cross-over, double-blind study versus placebo. Eur J Clin Pharmacol. 2003;59(3):179-88. https://doi.org/10.1007/s00228-003-0591-5 https://doi.org/https://doi.org/10.1007/...	RCT/crossover	n=49 (21M and 28F), between 64 and 78 years, healthy	Zolpidem (5 mg), Zopiclone (3.75 mg) and Lormetazepam (1 mg)	Placebo	CTT, LMT, Sternberg MRT, SRT, body sway test, and adverse events	Each treatment lasted 12 h, with a washout period of 8 days.
Fairweather et al., 1992¹⁸18. Fairweather D, Kerr J, Hindmarch I. The effects of acute and repeated doses of zolpidem on subjective sleep, psychomotor performance and cognitive function in elderly volunteers. Eur J Clin Pharmacol. 1992;43(6):597-601. https://doi.org/10.1007/bf02284957 https://doi.org/https://doi.org/10.1007/...	RCT/crossover	n=24 (6M and 18F), between 63 and 80 years, healthy	Zolpidem (5 mg) and Zolpidem (10 mg)	Placebo	CTT, CRT, Sternberg MRT, and WRT	Each treatment lasted 7 days (3 treatments in total), with a washout period of 7 days. They were analyzed after the first day and the last.

Author and year of publication	Focal matter	Randomization	Blindfold allocation	Double blind	Losses less<20%	Analysis by intention to treat	Prognostic characteristics	Outcome	Sample calculation	JADAD
Uemura et al., 2015¹³13. Uemura S, Kanbayashi T, Wakasa M, Satake M, Ito W, Shimizu K, et al. Residual effects of zolpidem, triazolam, rilmazafone and placebo in healthy elderly subjects: a randomized double-blind study. Sleep Med. 2015;16(11):1395-402. https://doi.org/10.1016/j.sleep.2015.05.021 https://doi.org/https://doi.org/10.1016/...										2
Boyle et al., 2009¹⁴14. Boyle J, Danjou P, Alexander R, Calder N, Gargano C, Agrawal N, et al. Tolerability, pharmacokinetics and night-time effects on postural sway and critical flicker fusion of gaboxadol and zolpidem in elderly subjects. Br J Clin Pharmacol. 2009;67(2):180-90. https://doi.org/10.1111/j.1365-2125.2008.03331.x https://doi.org/https://doi.org/10.1111/...										4
Zammit et al., 2008¹⁵15. Zammit G, Wang-Weigand S, Peng X. Use of computerized dynamic posturography to assess balance in older adults after nighttime awakenings using zolpidem as a reference. BMC Geriatr. 2008;8(1):15. https://doi.org/10.1186/1471-2318-8-15 https://doi.org/https://doi.org/10.1186/...										3
Hindmarch et al., 2006¹⁶16. Hindmarch I, Legangneux E, Stanley N, Emegbo S, Dawson J. A double-blind, placebo-controlled investigation of the residual psychomotor and cognitive effects of zolpidem-MR in healthy elderly volunteers. Br J Cli Pharmacol. 2006;62(5):538-45. https://doi.org/10.1111/j.1365-2125.2006.02705.x https://doi.org/https://doi.org/10.1111/...										4
Bentué-Ferrer et al., 2003¹⁷17. Bentué-Ferrer D, Allain H, Tarral A, Gandon J. Effects on postural oscillation and memory functions of a single dose of zolpidem 5 mg, zopiclone 3.75 mg and lormetazepam 1 mg in elderly healthy subjects. A randomized, cross-over, double-blind study versus placebo. Eur J Clin Pharmacol. 2003;59(3):179-88. https://doi.org/10.1007/s00228-003-0591-5 https://doi.org/https://doi.org/10.1007/...										3
Fairweather et al., 1992¹⁸18. Fairweather D, Kerr J, Hindmarch I. The effects of acute and repeated doses of zolpidem on subjective sleep, psychomotor performance and cognitive function in elderly volunteers. Eur J Clin Pharmacol. 1992;43(6):597-601. https://doi.org/10.1007/bf02284957 https://doi.org/https://doi.org/10.1007/...										3

Author and year of publication	Intervention ´ control	Cognitive dysfunctions
Author and year of publication	Intervention ´ control	CFF (Hz)	CTT	CRT
Uemura et al., 2015¹³13. Uemura S, Kanbayashi T, Wakasa M, Satake M, Ito W, Shimizu K, et al. Residual effects of zolpidem, triazolam, rilmazafone and placebo in healthy elderly subjects: a randomized double-blind study. Sleep Med. 2015;16(11):1395-402. https://doi.org/10.1016/j.sleep.2015.05.021 https://doi.org/https://doi.org/10.1016/...	Zolpidem (5 mg) ´ placebo	I: 33 (SEM=0.19) C: 32.4 (SEM=0.18)	No data	No data
Boyle et al., 2009¹⁴14. Boyle J, Danjou P, Alexander R, Calder N, Gargano C, Agrawal N, et al. Tolerability, pharmacokinetics and night-time effects on postural sway and critical flicker fusion of gaboxadol and zolpidem in elderly subjects. Br J Clin Pharmacol. 2009;67(2):180-90. https://doi.org/10.1111/j.1365-2125.2008.03331.x https://doi.org/https://doi.org/10.1111/...	Zolpidem (5 mg) ´ placebo	Zolpidem minus placebo (MD) 1 h 30: -0.53 (-1.20 to 0.14) 4 h: -0.1 (-0.77 to 0.57) 8 h: -0.05 (-0.72 to 0.62)	No data	No data
Hindmarch et al., 2006¹⁶16. Hindmarch I, Legangneux E, Stanley N, Emegbo S, Dawson J. A double-blind, placebo-controlled investigation of the residual psychomotor and cognitive effects of zolpidem-MR in healthy elderly volunteers. Br J Cli Pharmacol. 2006;62(5):538-45. https://doi.org/10.1111/j.1365-2125.2006.02705.x https://doi.org/https://doi.org/10.1111/...	Zolpidem (6.25 mg) and (12.5 mg) ´ placebo	Zolpidem minus placebo (MD) 6.25 mg: 0.2 (-0.38–0.77) 12.5 mg: -0.44 (-1.02–0.14) Performed 8 h after administration	Mean deviation (Pixels) (MD) 6.25 mg: -2.55 (-10.53–5.43) 12.5 mg: 4.20 (-3.78–12.18) Mean response time (ms) (MD) 6.25 mg: 19.59 (-113.56–74.39) 12.5 mg: 43.80 (-50.17–137.78)	Zolpidem minus placebo (DM) CRT - Recognition time (ms) 6.25 mg: -10.60 (-36.75 to 15.56) 12.5 mg: 11.18 (-14.97–37.33) CRT - Motor reaction time (ms) 6.25 mg: 9.16 (-12.51–30.82) 12.5 mg: 2.22 (-23.89–19.44) CRT - Total reaction time 6.25 mg: -1.44 (-35.13–32.26) 12.5 mg: 8.96 (-24.74–42.65)
Bentué-Ferrer et al., 2003¹⁷17. Bentué-Ferrer D, Allain H, Tarral A, Gandon J. Effects on postural oscillation and memory functions of a single dose of zolpidem 5 mg, zopiclone 3.75 mg and lormetazepam 1 mg in elderly healthy subjects. A randomized, cross-over, double-blind study versus placebo. Eur J Clin Pharmacol. 2003;59(3):179-88. https://doi.org/10.1007/s00228-003-0591-5 https://doi.org/https://doi.org/10.1007/...	Zolpidem (5 mg) ´ placebo	No data	Mean (±SEM) (mm) H0: I=11.41 (10.56–12.26) C=11.92 (11.13–12.71) H9: I=14.35 (12.44–16.26) C=12.32 (11.22–13.42)	No data
Fairweather et al., 1992¹⁸18. Fairweather D, Kerr J, Hindmarch I. The effects of acute and repeated doses of zolpidem on subjective sleep, psychomotor performance and cognitive function in elderly volunteers. Eur J Clin Pharmacol. 1992;43(6):597-601. https://doi.org/10.1007/bf02284957 https://doi.org/https://doi.org/10.1007/...	Zolpidem (5 mg) and (10 mg) ´ placebo	No data	Placebo RMSTE (units) - Mean (SD): Day 1 – Baseline=11.4 (7.4); 10H=13.3 (12.4); 12H=14.0 (11.6); 18H=13.2 (11.2); Day 7 – Baseline=13.8 (14.4); 10H=14.0 (16.3); 12H=15.2 (22.0); 18H=13.7 (12.7). Peripheral stimuli (ms) - Mean (SD): Day 1 – Baseline=0.43 (0.08); 10H=0.45 (0.13); 12H=0.46 (0.08); 18H=0.46 (0.1); Day 7 – Baseline=0.45 (0.1); 10H=0.43 (0.08); 12H=0.44 (0.07); 18H=0.46 (0.11) Zolpidem (5 mg) RMSTE (units) - Mean (SD): Day 1 – Baseline=12.7 (10.4); 10H=12.8 (9.6); 12H=13.4 (9.9); 18H=13.5 (10.2); Day 7 – Baseline=11.7 (9.5); 10H=12.6 (9.6); 12H=12.1 (8.5); 18H=12.1 (10.1). Peripheral stimuli (ms) - Mean (SD): Day 1 – Baseline=0.43 (0.07); 10H=0.43 (0.1); 12H=0.46 (0.1); 18H=0.45 (0.6); Day 7 - Baseline=0.43 (0.07); 10H=0.44 (0.07); 12H=0.45 (0.07); 18H=0.45 (0.06). Zolpidem (10 mg) RMSTE (units) - Mean (SD): Day 1 – Baseline=12.5 (10.8); 10H=13.3 (9.9); 12H=13.2 (9.9); 18H=13.4 (11.9); Day 7 – Baseline=11.5 (8.1); 10H=12.4 (10.1); 12H=12.7 (11.3); 18H=13.5 (12.1). Peripheral stimuli (ms) - Mean (SD): Day 1 – Baseline=0.43 (0.08); 10H=0.44 (0.07); 12H=0.46 (0.08); 18H=0.45 (0.08); Day 7 – Baseline=0.44 (0.08); 10H=0.44 (0.08); 12H=0.45 (0.07); 18H=0.46 (0.09).	“There was no statistically significant difference.”
Uemura et al., 2015¹³13. Uemura S, Kanbayashi T, Wakasa M, Satake M, Ito W, Shimizu K, et al. Residual effects of zolpidem, triazolam, rilmazafone and placebo in healthy elderly subjects: a randomized double-blind study. Sleep Med. 2015;16(11):1395-402. https://doi.org/10.1016/j.sleep.2015.05.021 https://doi.org/https://doi.org/10.1016/...	No data	Accuracy rate (%) I: 94.2 (SEM=1.1) C: 92.9 (SEM=0.9) Reaction time (s) I: 0.51 (0.01) C: 0.5 (0.01)	I: Accuracy rate (%)=34.6 (2.4) C: Accuracy rate (%)=32.1 (2.4)	No data	No data	No data	No data	No data
Boyle et al., 2009¹⁴14. Boyle J, Danjou P, Alexander R, Calder N, Gargano C, Agrawal N, et al. Tolerability, pharmacokinetics and night-time effects on postural sway and critical flicker fusion of gaboxadol and zolpidem in elderly subjects. Br J Clin Pharmacol. 2009;67(2):180-90. https://doi.org/10.1111/j.1365-2125.2008.03331.x https://doi.org/https://doi.org/10.1111/...	No data	No data	No data	No data	No data	No data	No data	No data
Hindmarch et al., 2006¹⁶16. Hindmarch I, Legangneux E, Stanley N, Emegbo S, Dawson J. A double-blind, placebo-controlled investigation of the residual psychomotor and cognitive effects of zolpidem-MR in healthy elderly volunteers. Br J Cli Pharmacol. 2006;62(5):538-45. https://doi.org/10.1111/j.1365-2125.2006.02705.x https://doi.org/https://doi.org/10.1111/...	No data	No data	No data	Zolpidem minus placebo (MD) (nº) 6.25 mg: 0.68 (-1.24–2.61) 12.5 mg: 0.73 (-1.2–2.65)	No data	No data	No data	Zolpidem minus placebo (MD) (nº) Immediate word recall 6.25 mg: -0.34 (-1.47–0.78) 12.5 mg: -0.68 (-1.8–0.45) Delayed word recall 6.25 mg: -0.08 (-1.29–1.13) 12.5 mg: -1.05 (-2.26–0.16)
Bentué-Ferrer et al., 2003¹⁷17. Bentué-Ferrer D, Allain H, Tarral A, Gandon J. Effects on postural oscillation and memory functions of a single dose of zolpidem 5 mg, zopiclone 3.75 mg and lormetazepam 1 mg in elderly healthy subjects. A randomized, cross-over, double-blind study versus placebo. Eur J Clin Pharmacol. 2003;59(3):179-88. https://doi.org/10.1007/s00228-003-0591-5 https://doi.org/https://doi.org/10.1007/...	Mean (SEM) 2 digits H0: I=825 (42) C=985 (62) H9: I=892 (40) C=923 (56) 3 digits H0: I=926 (34) C=953 (45) H9: I=933 (33) C=950 (44) 4 digits H0: I=982 (39) C=995 (39) H9: I=950 (34) C=997 (41) 5 digits H0: I=1027 (39) C=1073 (50) H9: I=1010 (34) C=1039 (42) 6 digits H0: I=1123 (64) C=1136 (63) H9: I=1084 (41) C=1052 (36)	No data	No data	No data	IFRL (H9) (nº) I: 5 (mean) C: 4 (mean) MFIR (H9) (nº) I: 7 (mean) C: 7 (mean) DFR (H10) (nº) I: 6 (mean) C: 6 (mean)	Mean (±SEM) (ms) H0: I=344.97 (305.37–384.57) C=320.61 (308.21–333.01) H4: I=323.45 (315.05–331.85) C=338.29 (328.29–348.29) H5: I=335.13 (325.53–344.73) C=345.17 (333.17–357.17) H6: I=345.62 (333.62–357.62) C=347.65 (335.65–359.65) H8: I=336.50 (324.90–348.10) C=354.13 (340.53–367.73) H10: I=316.57 (310.17–322.97) C=331.00 (319.40–342.60)	No data	No data
Fairweather et al., 1992¹⁸18. Fairweather D, Kerr J, Hindmarch I. The effects of acute and repeated doses of zolpidem on subjective sleep, psychomotor performance and cognitive function in elderly volunteers. Eur J Clin Pharmacol. 1992;43(6):597-601. https://doi.org/10.1007/bf02284957 https://doi.org/https://doi.org/10.1007/...	“There was no statistically significant difference.”	No data	No data	No data	No data	No data	“There was no statistically significant difference.”	No data

Author and year of publication	Intervention ´ control	Balance dysfunctions
		Body sway test	TUG	FRT	NeuroCom EquiTest SOT
Uemura et al., 2015¹³13. Uemura S, Kanbayashi T, Wakasa M, Satake M, Ito W, Shimizu K, et al. Residual effects of zolpidem, triazolam, rilmazafone and placebo in healthy elderly subjects: a randomized double-blind study. Sleep Med. 2015;16(11):1395-402. https://doi.org/10.1016/j.sleep.2015.05.021 https://doi.org/https://doi.org/10.1016/...	Zolpidem (5 mg) ´ placebo	Mean (SEM) (cm) Eyes open I: 141.7 (1.7) C: 143.4 (1.7) Eyes closed I: 171.9 (2.3) C: 172.3 (2.3)	Mean (SEM) (s) I: 7.61 (0.05) C: 7.67 (0.05)	Mean (SEM) (cm) I: 311.8 (4.0) C: 288.4 (4.2)	No data
Boyle et al., 2009¹⁴14. Boyle J, Danjou P, Alexander R, Calder N, Gargano C, Agrawal N, et al. Tolerability, pharmacokinetics and night-time effects on postural sway and critical flicker fusion of gaboxadol and zolpidem in elderly subjects. Br J Clin Pharmacol. 2009;67(2):180-90. https://doi.org/10.1111/j.1365-2125.2008.03331.x https://doi.org/https://doi.org/10.1111/...	Zolpidem (5 mg) ´ placebo	Zolpidem minus placebo (GM) (cm²) Eyes open 1 h 30: 2.00 (1.62–2.46) 4 h: 1.78 (1.44–2.20) 8 h: 1.23 (1.00–1.52) Eyes closed 1 h 30: 1.65 (1.33–2.04) 4 h: 1.38 (1.11–1.71) 8 h: 1.09 (0.88–1.35)	No data	No data	No data
Zammit et al., 2008¹⁵15. Zammit G, Wang-Weigand S, Peng X. Use of computerized dynamic posturography to assess balance in older adults after nighttime awakenings using zolpidem as a reference. BMC Geriatr. 2008;8(1):15. https://doi.org/10.1186/1471-2318-8-15 https://doi.org/https://doi.org/10.1186/...	Zolpidem (10 mg) ´ placebo	No data	No data	No data	LS mean (SE) (%) ES1: -6.67±2.02 ES2: -7.41±1.90 ES3: -6.35±2.78 ES4: -13.14±3.76 ES5: -27.69±5.38 ES6: -17.21±3.61 CES: -15.83±2.88 Somatosensory ratio: -1.74±1.60 Visual ratio: -8.76±4.00 Vestibular ratio: -27.43±5.91 Preference ratio: 12.82±5.90
Bentué-Ferrer et al., 2003¹⁷17. Bentué-Ferrer D, Allain H, Tarral A, Gandon J. Effects on postural oscillation and memory functions of a single dose of zolpidem 5 mg, zopiclone 3.75 mg and lormetazepam 1 mg in elderly healthy subjects. A randomized, cross-over, double-blind study versus placebo. Eur J Clin Pharmacol. 2003;59(3):179-88. https://doi.org/10.1007/s00228-003-0591-5 https://doi.org/https://doi.org/10.1007/...	Zolpidem (5 mg) ´ placebo	Mean (±SEM) (mm²) Eyes open H0: I=194.04 (180.24–207.84) C=185.78 (173.86–197.7) H4: I=297.85 (274.84–320.86) C=218.73 (204.92–232.54) H5: I=332.63 (303.18–362.08) C=239.71 (222.22–257.2) H6: I=332.45 (308.52–356.38) C=275.41 (254.25–296.57) H8: I=301.90 (270.61–333.19) C=240.26 (222.77–257.75) H10: I=194.96 (183.00–206.92) C=188.54 (176.58–200.5) Eyes closed H0: I=452.27 (398.73–505.81) C=483.53 (436.68–530.38) H4: I=711.96 (605.99–817.93) C=454.30 (414.14–494.46) H5: I=613.57 (552.22–674.92) C=447.39 (416.15–478.63) H6: I=703.70 (634.54–772.86) C=533.06 (492.90–573.22) H8: I=637.67 (568.50–706.84) C=502.72 (455.87–549.57) H10: I=441.12 (398.73–483.51) C=456.76 (414.37–499.15)	No data	No data	No data

[1] Guilherme Tavares. Rua Carolino Rodrigues, 17 – Boqueirão – 11055-070 Santos SP – Brazil. E-mail: tavaresguilherme18@gmail.com

Brasil

Brasil

Cognitive and balance dysfunctions due to the use of zolpidem in the elderly: a systematic review

Alterações cognitivas e de equilíbrio devido ao uso de zolpidem em idosos: uma revisão sistemática

ABSTRACT.

Objective:

Methods:

Results:

Conclusions: