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Medication use and risk of falls
C Ineke Neutel1, Sheril Perry, Colleen Maxwell
1University of Ottawa Institute on Health of the Elderly, 43 Bruyère Street, Ottawa, Ontario, Canada, K1N 5C8. ineutel@scohs.on.ca
Pharmacoepidemiology and Drug Safety
|May 10, 2002
Summary
Elderly individuals taking multiple medications or starting new benzodiazepines (BZD) and antipsychotics face a significantly higher risk of falls. Targeted monitoring and medication adjustments can help prevent these falls in high-risk groups.
Area of Science:
- Gerontology
- Pharmacology
- Public Health
Background:
- Falls are a major public health issue, especially for the elderly.
- Effective fall prevention strategies are crucial in institutionalized settings.
Purpose of the Study:
- To examine the link between drug use and falls in institutionalized elderly residents.
- To pinpoint specific high-risk patient subgroups for targeted fall prevention.
Main Methods:
- A 1-year observational study of 227 residents using logistic regression.
- A case-crossover design was employed to assess the risk of initiating new drug therapies.
- Odds ratios (ORs) were calculated to quantify the association between drug use and falls.
Main Results:
- While most drug classes showed weak associations with falls, benzodiazepines (BZD) had the highest unadjusted OR of 1.8.
- Polypharmacy, defined as using 10 or more drugs, significantly increased fall risk (OR = 6.1).
- Initiating new BZD or antipsychotic medications posed a very high fall risk (OR = 11.4).
Conclusions:
- Institutionalized residents taking numerous medications or starting new BZD/antipsychotics are at substantially elevated risk of falls.
- These identified high-risk groups warrant increased monitoring and potential medication regimen adjustments for fall prevention.