Falls Are Associated with Stroke, Arthritis and Multiple Medications among Community-Dwelling Elderly Persons in Japan

Abstract

Falls are a major public health problem and the second leading cause of death due to unintentional accidental injury after road traffic accidents. Inactive, older individuals with several chronic illnesses fall more frequently than older individuals who are active and healthy. No population-based study has addressed the association of stroke, arthritis, hypnotic and other prescription medications with falls among the elderly simultaneously in a single population in Japan. We examined the prevalence of falls among community-dwelling elderly Japanese individuals, whom we randomly selected from a list of inhabitants aged ≥ 65 years compiled from the resident registration, and the associations between falls and each of stroke, arthritis, and hypnotic and other prescription medications. We interviewed 295 men and 307 women, and collected information about the number of falls during the latest one year, hemiplegia due to stroke, arthritis in the legs, and the number of hypnotic and other medications. We found that 46 men (16%) and 67 women (22%) had fallen at least once during the latest one year. Logistic regression analysis adjusted for age showed that hemiplegia due to stroke (p < 0.001), arthritis in the legs (p < 0.001), and taking at least four daily prescription medications (p < 0.05) were significantly associated with falls in men. Arthritis in the legs (p = 0.05) and taking at least four daily prescription medications (p < 0.05) were associated with falls in women. Treatment of fall-related diseases and medication management are important strategies for reducing falls among elderly persons.

Predicting Falls in People Aged 65 Years and Older from Insurance Claims

“…Additionally, the guidelines recommend checking for orthostatic hypotension, visual impairment, and cognitive impairment as well as review of psychoactive medications. However, use of the guidelines relies on in-person clinical evaluation and often only takes into account a small portion of the risk factors among medications, 7–10 diagnoses, 8,11 and social issues. 12 .…”

Cair faz parte da vida: Fatores de risco para quedas em idosos Falling is a part of life: Falls risk factors to the elderly

“…Similar to other work 12 , elderly participants of this investigation, who have fallen, made use of at least one medication. The number of drugs was also a risk factor for falls in the elderly of a study conducted in Japan 13 , in which the use of three or more drugs associated with increased risk for falling. Thus, it is important to indicate the use of drugs, establish a careful evaluation of the real needs of its use or dosage adjustment, reducing the risk of falls.…”

“…As for what caused falls, the most common extrinsic factors were stairs without handrails and signaling (33% and 37.2%). A study of 602 elderly in a Japanese community also showed that the main cause of the fall was related to extrinsic factors, but these were related to tripping and slipping 13 . This demonstrates the importance of elderly housing adequacy to prevent the fall.…”

Effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and relevant pharmacological interventions on fall risk in elderly patients

“…35 Mizukami et al examined the prevalence of falls among communitydwelling elderly Japanese individuals, and found that taking at least four daily prescription medications (P,0.05) was significantly associated with falls. 36 Multivariate logistic regression analysis revealed that the overall OR of falling among patients using ten or more drugs was 8.42 (95% CI 4.73-15.0) compared with patients who used 0-1 drug per day. 37 Another study also showed particular risk for falling (OR 6.1) in patients taking 10+ drugs.…”