Association Between Sedative-Hypnotic Medication Use and Fall-Related Emergency Department Visits Among Older Adults

Falls are a leading cause of injury and emergency department visits among older adults. Medication use, including sedative hypnotics, may influence fall risk, but findings remain inconsistent across clinical settings.

This study examined the association between sedative hypnotic use and fall-related emergency department visits among older adults.

A retrospective cross-sectional analysis was conducted using the National Hospital Ambulatory Medical Care Survey emergency department data from 2014 to 2020. The study included adults aged 65 years and older. Fall-related visits were identified using external cause-of-injury codes, and sedative use was defined using Multum therapeutic class codes. Survey-weighted descriptive analyses were performed, and group comparisons were assessed using survey-adjusted t-tests and chi-square tests. Multivariable, survey-weighted logistic regression was used to evaluate associations while adjusting for demographic and clinical factors.

The analytic sample included 21,227 visits, representing 155,790,536 weighted visits. Fall-related visits were more common among older individuals and those with dementia. Sedative use was associated with lower odds of fall-related visits after adjustment for covariates (adjusted odds ratio = 0.74; 95% confidence interval = 0.55-0.98; p = 0.034). Age and dementia were associated with higher odds, while male sex and non-Hispanic Black, Hispanic, and non-Hispanic other groups had lower odds compared with non-Hispanic White individuals.

Sedative use was associated with lower odds of fall-related emergency visits in this population. These findings should be interpreted in the context of potential residual confounding and highlight the need for further research using longitudinal data.