Anticholinergic burden and the risk of falls among elderly psychiatric inpatients: a 4-year case-control study

Falls are an everyday risk for the elderly and their etiology is multifactorial. Because there are little data focusing on falls among elderly psychiatric inpatients, we aimed to retrospectively assess the characteristics of inpatients that had sustained a fall during hospitalization.

Over 4 years, all adverse-event reports of falls were reviewed. Inclusion criteria were age >65 years and intact cognition. The control group consisted of the previous and next admission of an elderly patient to the same ward. Anticholinergic score was calculated for each patient.

Of 414 admissions of elderly patients, 34 (8.2%) patients had had a fall. The control group (n = 68) did not differ in mean age, distribution of diagnoses, or use of benzodiazepines, antidepressants, or antipsychotics. Two variables were significantly associated with falls: female gender (68% vs. 39%, p < .05) and anticholinergic burden score (ABS) (mean: 3.7 vs. 2.1, p < .05).

Our results support reported findings of higher rates of falls among elderly women and suggest that ABS may be a risk factor for falls.