Alcohol and benzodiazepines in falls: an epidemiological view

Falls are common at all ages and especially in the elderly; it is important to understand contributing causes. Over a 1-year period we studied blood alcohol (BAC) and benzodiazepine concentrations in patients attending an emergency department because of a fall. The 22% of 615 patients tested were positive for alcohol, 55% were positive for benzodiazepines (BZD) and 1.5% were positive for both substances. A significantly larger proportion of males tested positive for alcohol (40.2%) than females (7.6%). Both in males and females the percentage as well as the extent of blood alcohol levels decreased significantly with age. Benzodiazepines were also consumed more frequently in males (8.5%) than in females (3.2%, p=0.007). Concerning BAC there was no difference between males (1.75+/-0.81 g/l) and females (1.66+/-0.91 g/l). In patients older than 70 years the BAC (1.30+/-0.80 g/l) was lower in comparison to younger ones. All blood samples positive for benzodiazepines could be traced back to diazepam consumption. We found a high number of young and middle aged patients using alcohol (males=49.7%; females=18.9%) and a lower but still relevant number of benzodiazepine users (males=9.5%; females=2.4%). In addition, this study shows that alcohol plays a more important role in patients up to 70 years in fall-related accidents when compared to accidents of other causes.