Medication use and falls in community-dwelling seniors

Purpose The association between injurious falls requiring a visit to the emergency department and various classes of medications was examined in a case–control study of community living persons aged 66 years and older. It was hypothesized that medication use was related to injurious falls while controlling for comorbidity. Methods Administrative databases from a Canadian province provided the information used. Data were collected for all community-dwelling seniors aged 66 and older (n = 282,519) in the study year. Two series of analyses on medication use within 30 days of the fall were conducted using logistic regression; the first controlling for age, sex, socioeconomic status, and rural residence, and the second controlling for comorbid diagnoses as well. Results During the study year there were 9152 falls reported by 8534 individuals to provincial hospital emergency departments giving a crude fall rate of 32.4 per 1000 population per year (95% CI = 32.3, 32.5). The initial analysis identified 10 medication classes that were associated with an increased risk of an injurious fall, while controlling for age, sex, socioeconomic status, and rural residence. With further analysis controlling for the additional effects of comorbid disease, narcotic pain killers (odds ratio OR = 2.06, 95% confidence interval CI = 1.93, 2.17), anti-Parkinson agents (OR = 1.55, 95% CI = 1.26, 1.91), antidepressants (OR = 1.33, 95% CI = 1.23, 1.43), anticonvulsants (OR = 1.20, 95% CI = 1.07, 1.36), anticoagulants (OR = 1.20, 95% CI = 1.09, 1.33), electrolytic or water balance agents (OR = 1.19, 95% CI = 1.13, 1.26), antipsychotics (OR = 1.16, 95% CI = 1.01, 1.38), corticosteroids (OR = 1.13, 95% CI = 1.04, 1.22), and thyroid agents (OR = 1.07, 95% CI = 1.01, 1.15) remained as significant independent predictors of sustaining an injurious fall. Conclusion These results are based on a Canadian population-based study with a large community sample. The study found that taking certain medications were independent predictors of sustaining an injurious fall in the elderly population in addition to the risk associated with their medical conditions.