Laxatives as a Risk Factor for Iatrogenic Falls in Elderly Subjects

Bloch, Frédéric; Thibaud, Marie; Dugué, Benoît; Brèque, Cyril; Rigaud, Anne‐Sophie; Kemoun, G.

doi:10.2165/11584280-000000000-00000

Cited by 15 publications

(19 citation statements)

References 20 publications

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“…However, there is no proven causal link between laxative drugs and falls. A recent meta-analysis14 showed that elderly subjects treated with laxatives were twice as likely to fall compared with nonlaxative users. The causal relationship was probably not directly linked with a side effect of the substance used, but rather a reflection of other pathologies that may cause falls.…”

Section: Risk Factorsmentioning

confidence: 99%

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Iatrogenic disease in the elderly: risk factors, consequences, and prevention

Permpongkosol¹

2011

CIA

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The epidemiology of iatrogenic disease in the elderly has not been extensively reported. Risk factors of iatrogenic disease in the elderly are drug-induced iatrogenic disease, multiple chronic diseases, multiple physicians, hospitalization, and medical or surgical procedures. Iatrogenic disease can have a great psychomotor impact and important social consequences. To identify patients at high risk is the first step in prevention as most of the iatrogenic diseases are preventable. Interventions that can prevent iatrogenic complications include specific interventions, the use of a geriatric interdisciplinary team, pharmacist consultation and acute care for the elderly units.

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Section: Risk Factorsmentioning

confidence: 99%

“…The authors of a previous meta-analysis urged prescribers to change their habits with respect to the management of constipation in elderly subjects 14. The risk/benefit ratio of the drugs administered could be improved with better knowledge of the patients’ medical histories and risk factors for adverse drug events 7…”

Section: Preventionmentioning

confidence: 99%

Iatrogenic disease in the elderly: risk factors, consequences, and prevention

Permpongkosol¹

2011

CIA

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“…Meta-analyses on drugs [19][20][21][22][23], muscle weakness [24], balance impairment [25], sociodemographic items [26] and fall risk in older persons have all been carried out. That said, the only meta-analysis performed on exercises aimed at preventing falls is quite recent and dealt only with randomised controlled trials (RCTs) [27].…”

Section: Introductionmentioning

confidence: 99%

Impact of physical activity and sedentary behaviour on fall risks in older people: a systematic review and meta-analysis of observational studies

Thibaud

Bloch

Tournoux-Facon

et al. 2011

Eur Rev Aging Phys Act

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104

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“…Because laxative use may have different effects on various subpopulations, we additional undertook several subgroup analyses [28,59,60]. Laxative use was associated with an increased hazard for total fractures by age in women older than 65 years (HR, 1.06; 95% CI, 0.99-1.14, interaction p-value = 0.05), although no significant interaction by age was found for falls and hip fractures.…”

Section: Resultsmentioning

confidence: 99%

“…Several intrinsic and extrinsic effects of laxatives have been associated with their use providing potential mechanisms for an altered risk for falls and bone outcomes [2,5,9,25,28,61]. Extrinsically, laxatives can increase the urgency to void with resulting higher risk of falling.…”

Section: Discussionmentioning

confidence: 99%

Laxative use and incident falls, fractures and change in bone mineral density in postmenopausal women: results from the Women’s Health Initiative

et al. 2013

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BackgroundLaxatives are among the most widely used over-the-counter medications in the United States but studies examining their potential hazardous side effects are sparse. Associations between laxative use and risk for fractures and change in bone mineral density [BMD] have not previously been investigated.MethodsThis prospective analysis included 161,808 postmenopausal women (8907 users and 151,497 nonusers of laxatives) enrolled in the WHI Observational Study and Clinical Trials. Women were recruited from October 1, 1993, to December 31, 1998, at 40 clinical centers in the United States and were eligible if they were 50 to 79 years old and were postmenopausal at the time of enrollment. Medication inventories were obtained during in-person interviews at baseline and at the 3-year follow-up visit on everyone. Data on self-reported falls (≥2), fractures (hip and total fractures) were used. BMD was determined at baseline and year 3 at 3 of the 40 clinical centers of the WHI.ResultsAge-adjusted rates of hip fractures and total fractures, but not for falls were similar between laxative users and non-users regardless of duration of laxative use. The multivariate-adjusted hazard ratios for any laxative use were 1.06 (95% confidence interval [CI], 1.03-1.10) for falls, 1.02 (95% CI, 0.85-1.22) for hip fractures and 1.01 (95% CI, 0.96-1.07) for total fractures. The BMD levels did not statistically differ between laxative users and nonusers at any skeletal site after 3-years intake.ConclusionThese findings support a modest association between laxative use and increase in the risk of falls but not for fractures. Its use did not decrease bone mineral density levels in postmenopausal women. Maintaining physical functioning, and providing adequate treatment of comorbidities that predispose individuals for falls should be considered as first measures to avoid potential negative consequences associated with laxative use.

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Laxatives as a Risk Factor for Iatrogenic Falls in Elderly Subjects

Cited by 15 publications

References 20 publications

Iatrogenic disease in the elderly: risk factors, consequences, and prevention

Iatrogenic disease in the elderly: risk factors, consequences, and prevention

Impact of physical activity and sedentary behaviour on fall risks in older people: a systematic review and meta-analysis of observational studies

Laxative use and incident falls, fractures and change in bone mineral density in postmenopausal women: results from the Women’s Health Initiative

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