Popular Prescription Medications May Contribute to Falls, Injuries in Elderly Patients

Elderly falls and injuries may be attributed to many popular prescription medications.

The adverse effects of commonly prescribed medications may threaten the wellbeing of elderly patients, according to research published in the European Journal of Public Health.

Researchers from the Karolinska Institutet in Stockholm, Sweden, studied nearly 7 million patients aged 65 years or older and identified 64,399 elderly individuals who were admitted to the hospital for a fall or injury between March 2006 and December 2009.

Each participants was matched with 4 controls based on gender, date of birth, and place of residence. The researchers also took note of the 20 most commonly prescribed medications for all participants, dating back 30 days prior to their injury or fall.

“Elderly are often prescribed medications and are also a group in society frail to falls leading to serious consequences for their health and quality of life,” study author Jette Möller told Pharmacy Times in an exclusive interview. “Several studies have pointed to medications as playing an important role for their risk of fall and fall injuries, (but) many of these medications have not been studied with regard to the risk of serious fall injuries, and population-based studies using the same design and material to explore the effects are very limited.”

The researchers noted a gender-based difference, as women were 75% more likely to have a fall injury compared to their non-medicated counterparts. Men and women taking opioid analgesics were more than twice as likely to be hospitalized for a fall injury than their non-medicated counterparts. Similarly, men taking antidepressants were 2 times as likely to have a fall than elderly patients who were not taking such drugs.

Of the 20 most commonly prescribed drugs, 10 medications—especially 3 that affect the central nervous system (CNS)—significantly increased the risk of injuries from falling. The highest risk was seen with the use of opioids and antidepressants, although hypnotics, sedatives, and analgesics were also of concern.

Drugs prescribed for ulcers and gastroesophageal reflux disease, calcium, vitamin B12, and some non-opioid analgesics were linked to a wide rangeof all fall injuries.

Möller explained that some drugs might not cause falls; rather, an elderly individual’s injuries may be due to a disorder the drug is prescribed to treat, such as osteoporosis. The cardiovascular medications, however, “showed what we call a ‘protective’ effect, and many of them had not been specifically studied previously,” Möller continued.

Despite their findings, the researchers did not at all recommend halting any prescribing of the drugs.

“Although we can assume that the risk for individual patients to sustain injurious falls would be minimized by not prescribing these medications, they may still remain essential in other critical aspects of health and wellbeing,” Möller concluded. “This is even more problematic in instances where there are no non-fall-inducing medications as a substitute.”