Medication use and increased risk of falls in hospitalized elderly patients: a retrospective, case-control study

Falls in the elderly are common and often serious. Several drugs have been associated with increased fall risk. Older adults often take numerous medications for multiple chronic conditions, so are at increased risk for drugs that potentially cause falls.

We studied the association between drug use and falls in recently hospitalized older people in order to identify medications that may increase the risk of falls in this population.

A retrospective case control study was performed in the geriatric department of Bertinot Juel Hospital, Chaumont en Vexin, Picardy, France. We assessed the incidence of patient falls during hospitalization in 2004 and 2005 in an acute geriatric ward. We compared medications taken by all patients who fell (134 cases) with those taken by patients who did not fall (126 controls). The 260 participants were all aged >or=65 years.

50% of falls occurred in the first week after admission. In 16% of cases, falls were classified as severe. The characteristics of the two groups (patients who fell and those who did not) were similar: no significant differences were observed in terms of age, sex, number of medicines or prevalence of hypertension or Parkinson's disease. The probability of falls increased when the patients used zolpidem (adjusted odds ratio [AOR] 2.59; 95% CI 1.16, 5.81; p = 0.02), meprobamate (AOR 3.01; 95% CI 1.36, 6.64; p = 0.01) or calcium channel antagonists (AOR 2.45; 95% CI 1.16, 4.74; p = 0.02).

Some drugs are associated with an increased risk of falls in the elderly and, when alternatives exist, should be avoided until cohort studies are conducted to confirm or refute these possible increased risks.