Psychoactive Drug Use and Falls among Community-Dwelling Turkish Older People

Abstract

F alls are a significant common problem in older adults, reducing function and quality of life, increasing the risk for fear of falling syndrome, and causing morbidity and mortality. One-third of community-dwelling people aged over 65 years fall one or more times each year and repeated falls occur in half of them [1]. Brain trauma, hip fractures, hospitalization and death are worst outcomes of falls. Accidents are the seventh cause of deaths in older people and the majority are associated with falls [2]. Most falls arise from one or more combination risk factors, including advanced age, impaired cognitive function, comorbidities, sensory factors and environmental hazards. Drugs are another major modifiable risk factor for falls. Of those, psychoactive drugs are the most common cause associated with falls, with sedation, impaired balance, and coordination that result in gait problems. Psychoac-ABSTRACT OBJECTIVE: Data on the relationship between fall and psychoactive drug use among Turkish older people are limited. This study aims to investigate the prevalence of falls and the associations between psychoactive drug use and falls in communitydwelling Turkish older people. METHODS: This single center study was performed using the medical records of subjects aged over 65 years admitted to the geriatric care unit. Demographic and lifestyle factors, clinical characteristics, medications, and data on mood, cognitive status, and functional performance were obtained from the comprehensive geriatric assessment records. Based on a fall history in the last 12 months, subjects were grouped as fallers and non-fallers. Subjects treated with a psychoactive drug were identified. RESULTS: Among the total of 429 subjects, there were 184 (42.9%) fallers and 245 (57.1%) non-fallers. Of those, 33.3% were on psychoactive drug treatment. The proportion of psychoactive drug users was higher in the fallers group compared to non-fallers (45.1% vs. 24.5%, p<0.001). Multivariable logistic regression analysis showed age ≥75 years (OR=1.83; CI: 1.09-3.09; p=0.023), female gender (OR=2.70; CI: 1.6-4.50; p<0.001), and psychoactive drug use (OR=2.14; CI: 1.32-3.48; p=0.002) as independent predictors of falls. CONCLUSION: We found that about one-third of geriatric outpatients were on psychoactive drug treatment in Turkey that was independently associated with the risk of falls.

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“…When determining the relationship between the consumption of benzodiazepines, opioids, and tricyclic antidepressants and falls, a study showed that variables age, sex, and sensory conditions remain significantly associated, and negatively so with cannabis consumption [53]. In a recent study in Turkey, psychoactive drug treatment was found to be independently associated with the risk of falls [54]. Pratt et al (2014) discovered that increasing the number or doses of psychoactive medications was related to an increased risk of hospitalization after a fall [53].…”