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Using multiple fall risk-increasing drugs (FRIDs) significantly elevates the risk of fall-related injuries in older adults. Deprescribing high-risk FRIDs is crucial for effective fall prevention strategies.

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Area of Science:

  • Gerontology
  • Pharmacology
  • Public Health

Background:

  • Commonly prescribed medications are known to individually increase fall risk.
  • The impact of using multiple fall risk-increasing drugs (FRIDs) on fall-related injuries is less understood.
  • Older adults in home care (HC) and long-term care (LTC) settings are particularly vulnerable.

Purpose of the Study:

  • To examine the association between 12 major FRID classes, used alone and in combination, and fall-related injuries.
  • To compare the risk of fall-related injuries associated with FRID use in HC versus LTC populations.
  • To identify specific FRID classes with the highest associated risk.

Main Methods:

  • A matched case-control study design was employed.
  • Data were collected from HC recipients and LTC residents in Ontario, Canada, between 2008 and 2016.
  • Multivariable logistic regression analyzed FRID exposure in the 90 days preceding falls, matched for sex, age, fall history, calendar year, and disease risk score.

Main Results:

  • Any FRID use increased fall-related injury risk in both HC (aOR, 1.34) and LTC (aOR, 1.54) populations compared to non-users.
  • Dopaminergic agents and antidepressants showed the highest odds of fall-related injuries.
  • Exposure to five or more FRIDs nearly doubled the odds of fall-related injury in both HC (aOR, 1.67) and LTC (aOR, 1.92) settings.

Conclusions:

  • Multiple categories of FRIDs are significantly associated with increased fall-related injury risk in older adults.
  • Clinicians should prioritize minimizing the use of these medications whenever feasible.
  • Fall prevention programs must integrate strategies for the deprescription of high-risk FRIDs.