C Ineke Neutel1, Sheril Perry, Colleen Maxwell. 1. University of Ottawa Institute on Health of the Elderly, 43 Bruyère Street, Ottawa, Ontario, Canada, K1N 5C8. ineutel@scohs.on.ca
Abstract
PURPOSE: Injuries due to falls are an important public health concern, particularly for the elderly, and effective prevention is an ongoing endeavour. The present study has two related objectives: (1) to describe associations between drug use and falls in an institutionalized population, and (2) to identify a high risk subgroup within the larger population. METHODS: The initial analysis was based on a population of 227 residents who were followed over a 1-year period. Logistic regression techniques were used to estimate odds ratios (ORs) of the association of falls and drug use. The study of potential 'high-risk' groups employed a case-crossover design to estimate the risk of falling associated with starting a new drug course. RESULTS: Relatively weak ORs for risk of falling were observed for various drug classes; the highest OR was for benzodiazepines (BZD) at OR = 1.8 (unadjusted). Residents taking multiple drugs were at particular risk for falling, e.g. an OR of 6.1 for those using 10+ drugs. The case-crossover analysis indicated that residents starting a new BZD/antipsychotic were at very high risk (OR = 11.4) for experiencing a fall. CONCLUSIONS: Residents who took many different types of medications, as well as residents starting a new BZD/antipsychotics were at greatly increased risk of falling. These are high risk groups where increased monitoring or adjustments to drug regimens could lead to prevention of falls.
PURPOSE: Injuries due to falls are an important public health concern, particularly for the elderly, and effective prevention is an ongoing endeavour. The present study has two related objectives: (1) to describe associations between drug use and falls in an institutionalized population, and (2) to identify a high risk subgroup within the larger population. METHODS: The initial analysis was based on a population of 227 residents who were followed over a 1-year period. Logistic regression techniques were used to estimate odds ratios (ORs) of the association of falls and drug use. The study of potential 'high-risk' groups employed a case-crossover design to estimate the risk of falling associated with starting a new drug course. RESULTS: Relatively weak ORs for risk of falling were observed for various drug classes; the highest OR was for benzodiazepines (BZD) at OR = 1.8 (unadjusted). Residents taking multiple drugs were at particular risk for falling, e.g. an OR of 6.1 for those using 10+ drugs. The case-crossover analysis indicated that residents starting a new BZD/antipsychotic were at very high risk (OR = 11.4) for experiencing a fall. CONCLUSIONS: Residents who took many different types of medications, as well as residents starting a new BZD/antipsychotics were at greatly increased risk of falling. These are high risk groups where increased monitoring or adjustments to drug regimens could lead to prevention of falls.
Authors: Sarah D Berry; Yuqing Zhang; Lewis A Lipsitz; Murray A Mittleman; Daniel H Solomon; Douglas P Kiel Journal: J Gerontol A Biol Sci Med Sci Date: 2011-07-15 Impact factor: 6.053
Authors: Nalaka S Gooneratne; Philip Gehrman; Indira Gurubhagavatula; Erica Al-Shehabi; Elisabeth Marie; Richard Schwab Journal: J Clin Sleep Med Date: 2010-12-15 Impact factor: 4.062