The relation between falls and medication use among elderly in assisted living facilities

Abstract

Purpose: Many elderly are concerned about falling transfer to assisted living facilities (ALF). Previous literatures studied the medication use and falls in the community, hospitals, or nursing homes, with scanty data about ALF. Therefore, the aim of the current case-control study was to assess the relation between medication use and falls among elderly in ALF. Methods:A matched case-control study was conducted. The study was conducted in ALF in Cairo, Egypt. The study participants were 188 individuals; they were subdivided into two groups: fallers and nonfallers; timed up and go test (TUGT) was performed by all subjects. Medication data were collected according to the fall riskincreasing drugs list and the list of drugs that cause or worsen orthostatism. Other fall risk factors, as suggested by American Geriatric Society, were assessed.Results: The use of vasodilators, diuretics, alpha blockers, opioids, antipsychotics, and sedative hypnotics were more common in fallers than in nonfallers (P < 0.001, P = 0.03, P < 0.001, P = 0.013, P < 0.001, and P < 0.001, respectively). Vasodilators, alpha blockers, and antipsychotics were significant predictors of falls even after adjustment for the possible confounding factors. Vasodilators, alpha blockers, opioids, sedative hypnotics, and recent dose changes in oral hypoglycemics were significant predictors of higher TUGT after adjustment for the possible confounding factors. Conclusion:The current study supported the risk of psychotropic and cardiovascular medications, with especial emphasis on vasodilators, alpha blockers, and antipsychotics, with raising concern about opioids, sedative hypnotics, and recent dose change in oral hypoglycemics.

Association of drug therapy with falls in elderly and senile patients: Subanalysis of the epidemiological study EVKALIPT

“…S.A. Hamza и соавт. указали, что вазодиляторы, диуретики, альфа-блокаторы и антипсихотики являются значимыми предикторами падений [24]. В других исследованиях показано, что НПВП, инсулин, антигипертензивные препараты, антиаритмики повышают риск падений [25][26][27].…”

Deficits in pain medication in older adults with chronic pain receiving home care: A cross-sectional study in Germany

“…However, the use of opioids for persistent pain is not without limitations particularly in the treatment of older adults because of changes in their pharmacodynamic and pharmacokinetic profile that may require dose adjustments [41]. Their long-term use may result in serious adverse effects such as sedation, impaired balance and falls [41] in the vulnerable elderly population exposed to polypharmacy [42].…”

Relação entre a mobilidade funcional e a polimedicação para o risco de quedas em idosos

“…Sendo que era esperado que estas variáveis fossem diretamente proporcionais ao aumento do risco de queda. Hamza (2019) afirma que os sedativos hipnóticos são preditadores significativos de um tempo maior no TUG (Hamza & Abdelrahman, 2019), o que será esperado também para as restantes categorias medicamentosas que provocam as mesmas reações, porém, tal relação não foi observada no presente estudo, tendo-se obtido um coeficiente de correlação sem significado estatístico (r=-,137) (Pestana, n.d.).…”