Withdrawal of Fall‐Risk‐Increasing Drugs in Older Persons: Effect on Tilt‐Table Test Outcomes

Velde, Nathalie van der; Meiracker, Anton H. van den; Pols, Huibert A. P.; Stricker, Bruno H. Ch.; Cammen, Tischa J. M. van der

doi:10.1111/j.1532-5415.2007.01137.x

Cited by 64 publications

(40 citation statements)

References 44 publications

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“…1,6,17,26 A prospective study on fall risk showed that withdrawal of cardiovascular drugs led to lower fall risk and a reduction in OH. 27,28 Although a relationship between OH and falling was suggested in this study, causality was not proven. Observational studies show conflicting evidence regarding the association between OH and fall incidents.…”

Section: Comparison With Existing Literaturementioning

confidence: 96%

Orthostatic hypotension, diabetes, and falling in older patients: a cross-sectional study

Hateren¹,

Kleefstra²,

Blanker³

et al. 2012

Br J Gen Pract

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Section: Comparison With Existing Literaturementioning

confidence: 96%

Orthostatic hypotension, diabetes, and falling in older patients: a cross-sectional study

Hateren¹,

Kleefstra²,

Blanker³

et al. 2012

Br J Gen Pract

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“…Given the significant association between normalization of tilttable test outcomes and nonoccurrence of falls, Van der Velde et al (2007) comment that it is likely that part of the reduction in falls after FRID withdrawal in this cohort of geriatric patients was due to improvement in OH and in CSH. In this study, FRID-related falls were mediated through cardiovascular side effects.…”

Section: Illness Versus Medications and The Risk Of Fallsmentioning

confidence: 93%

“…This question was examined in the context of studies bearing on the risk of falls; there is evidence that the same medications that mediate falls risk may also mediate motor vehicle crash risk. What emerges in this review is that some geriatric patients experience an increased risk of falling due to cardiovascular adverse effects of sedatives, antihypertensives, and other medications, and that when these fall-risk-increasing drugs are withdrawn there is a resulting, persistent benefit ⎯ a significant reduction in the occurrence of falls (Van der Velde et al, 2007). At the same time, researchers have found that chronic medical conditions were often more important than medications in causing falls in high-functioning community-dwelling older people (Lee et al, 2006).…”

mentioning

confidence: 99%

A pilot study to test multiple medication usage and driving functioning

Staplin¹,

Lococo²,

Gish³

et al. 2008

PsycEXTRA Dataset

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John Siegler was the NHTSA Task Order Manager on this project. AbstractThe use of medications and multiple medications becomes more prevalent with increasing age. This pilot study explored the relationship between polypharmacy and driving functioning through separate but related research activities. A patient-level administrative claims database containing prescription information as well as E-codes identifying the incidence of motor vehicle injuries was mined, yielding combinations of drugs that became inclusion criteria in a following field study of driver performance among 44 older adults (range: 57 to 89; mean: 79). Driving performance evaluations by an OT/CDRS, a brake response time measure, and functional screening measures were conducted for the study sample, whose drug profiles were documented through a "brown bag" review by a licensed pharmacist. The relationship between medication usage and each of these outcome measures was examined in descriptive data summaries and regression analyses. The driving evaluations were carried out in a dual-brake vehicle also equipped with speed sensor (OBD-2), GPS logger, and two miniature video cameras (driver's face and forward road views) plus digital recorder. A subsample allowed the same instrumentation package to be installed in their private cars for a week of independent driving; this supported an analysis of within-subject variability in driving behavior during a formal driving evaluation versus independent driving.Additional project activities included a current (to October 2007) review of the literature on the prevalence of prescription medications and effects on driving of specific drugs/drug classes. The feasibility of conducting future studies using large, administrative claims databases was critically examined, with an overview of candidates and evaluation of their suitability for NHTSA research. This report concludes with a discussion of project findings and recommendations for future research. Key WordsDrugs, medications, driver impairing, driver function, safety, performance, database analysis, instrumented vehicle, video analysis, behavioral analysis. Distribution StatementThis report is free of charge from the NHTSA Web site at www.nhtsa. EXECUTIVE SUMMARYThe number of older licensed drivers in the United States is growing at a rate faster than the overall population. As people age, they are more likely to take one or more potentially driver-impairing (PDI) medications. TransAnalytics, LLC, completed a pilot study to gain a better understanding of the safety impact on older drivers of taking multiple PDI medications, providing an update on the prevalence of prescription medications in the older population, and the effects on driving of specific drugs/drug classes. Research activities included a literature review; a data mining exercise; the prioritization of other databases for future data mining; and a field study including on-road evaluations of older drivers who take multiple PDI medications by an occupational therapist, and associated instrum...

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“…(22) Tilt training: OH will benefit from tilting the head during sleep to reduce the vasovagal reflexes. (23) Outcome is dependent on patient compliance.…”

Section: Psychogenic and Hyperventilation Syncopementioning

confidence: 99%

Syncope

2017

AGEMS

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Withdrawal of Fall‐Risk‐Increasing Drugs in Older Persons: Effect on Tilt‐Table Test Outcomes

Cited by 64 publications

References 44 publications

Orthostatic hypotension, diabetes, and falling in older patients: a cross-sectional study

Orthostatic hypotension, diabetes, and falling in older patients: a cross-sectional study

A pilot study to test multiple medication usage and driving functioning

Syncope

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