Many studies describing an association of drugs with falls focus mostly on drugs acting in the central nervous system. We aim to analyze the association of all drugs taken with falls in older adults.
Prospective population-based study (ActiFE study).
Setting and Participants
A total of 1377 community-dwelling older adults with complete recording of falls and baseline information on drug intake.
Negative binomial regression was used to analyze the association of 34 drug classes with a 12-month incidence rate ratio (IRR) of falls adjusting for age, sex, comorbidities, gait speed, balance, chair rise, kidney function, liver disease, and smoking.
Participants took a median 3 drugs (interquartile range 1, 5), with 34.5% (n = 469) having ≥5 drugs. The median IRR for a fall per person-year was overall 0.72 [95% confidence interval (CI) 0.60–0.83] and 2.22 (95% CI 1.90–2.53) among those who experienced ≥1 fall. The following drug classes showed significant associations: antiparkinsonian medication [IRR 2.68 (95% CI 1.59–4.51)], thyroid therapy [IRR 1.40 (95% CI 1.08–1.81)], and systemic corticosteroids [IRR 0.33 (95% CI 0.13–0.81)]. Among fall-risk-increasing drugs only antiepileptics [IRR 2.16 (95% CI 1.10–4.24)] and urologicals [IRR 2.47 (95% CI 1.33–4.59)] were associated with falls in those participants without a prior fall history at baseline.
Conclusion and Implications
Additional drug classes, such as antiparkinsonian medication, thyroid therapy, and systemic corticosteroids, might be associated with falls in older adults, possibly representing pharmacological effects on the musculoskeletal and central nervous systems. Further evaluations in larger study populations are recommended.
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Published online: January 28, 2021
K.S.J. and D.D. contributed equally.
The authors declare no conflicts of interest.
The study was supported by a grant from the Ministry of Science, Research and Arts, State of Baden-Wuerttemberg, Germany (DE2674/1–1). The sponsor had no role in the design, methods, subject recruitment, data collections, analysis and preparation of the paper.
© 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.