Medication use and risk of falls

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Abstract
Purpose Injuries due to falls are an important public health concern, particularly for the elderly, and effective prevention is an ongoing endeavour. The present study has two related objectives: (1) to describe associations between drug use and falls in an institutionalized population, and (2) to identify a high risk subgroup within the larger population. Methods The initial analysis was based on a population of 227 residents who were followed over a 1‐year period. Logistic regression techniques were used to estimate odds ratios (ORs) of the association of falls and drug use. The study of potential ‘high‐risk’ groups employed a case–crossover design to estimate the risk of falling associated with starting a new drug course. Results Relatively weak ORs for risk of falling were observed for various drug classes; the highest OR was for benzodiazepines (BZD) at OR=1.81 (unadjusted). Residents taking multiple drugs were at particular risk for falling, e.g. an OR of 6.11 for those using 10+ drugs. The case–crossover analysis indicated that residents starting a new BZD/antipsychotic were at very high risk (OR = 11.41) for experiencing a fall. Conclusions Residents who took many different types of medications, as well as residents starting a new BZD/antipsychotics were at greatly increased risk of falling. These are high risk groups where increased monitoring or adjustments to drug regimens could lead to prevention of falls. Copyright © 2002 John Wiley & Sons, Ltd.