Abstract
Objectives
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.
Design
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.
Methods
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.
Results
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.
Keywords
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Article info
Publication history
Published online: January 28, 2021
Footnotes
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.
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© 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
