Drug Burden and its Association with Falls Among Older Adults in New Zealand: A National Population Cross-Sectional Study

Background Adverse outcomes associated with advanced diseases are often exacerbated by polypharmacy. Objectives The current study investigated an association between exposure to anticholinergic and sedative medicines and falls in community-dwelling older people, after controlling for potential confo...

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Bibliographic Details
Published in:Drugs & aging 2018-01, Vol.35 (1), p.73-81
Main Authors: Jamieson, Hamish A., Nishtala, Prasad S., Scrase, Richard, Deely, Joanne M., Abey-Nesbit, Rebecca, Connolly, Martin J., Hilmer, Sarah N., Abernethy, Darrell R., Schluter, Philip J.
Format: Article
Language:English
Subjects:
Age
Aging
Analgesics
Anesthesia
Chronic obstructive pulmonary disease
Computerized physician order entry
Cross-sectional studies
Drug dosages
Fractures
Frailty
Geriatrics
Geriatrics/Gerontology
Internal Medicine
Medicine
Medicine & Public Health
Mortality
Older people
Original Research Article
Pharmacology/Toxicology
Pharmacotherapy
Population
Prescription drugs
Systematic review
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Summary:Background Adverse outcomes associated with advanced diseases are often exacerbated by polypharmacy. Objectives The current study investigated an association between exposure to anticholinergic and sedative medicines and falls in community-dwelling older people, after controlling for potential confounders. Methods We conducted a retrospective cross-sectional study of a continuously recruited national cohort of community-dwelling New Zealanders aged 65 years and over. Participants had an International Resident Assessment Instrument–Home Care (interRAI-HC) assessment between 1 September 2012 and 31 January 2016. InterRAI-HC is a comprehensive, multi-domain, standardised assessment. This study captured 18 variables, including fall frequency, from the interRAI. These data were deterministically matched with the Drug Burden Index (DBI) for each participant, derived from an anonymised national dispensed pharmaceuticals database. DBI groupings were statistically ascertained, and ordinal regression models employed. Results Overall, there were 71,856 participants, with a mean age of 82.7 years (range 65–106); 43,802 (61.0%) were female, and 63,578 (88.5%) were New Zealand European. In unadjusted and adjusted analyses, DBI groupings were related to falls ( p   3 was associated with a 41% increase in falls compared with a DBI score of 0 ( p  
ISSN:1170-229X
1179-1969
DOI:10.1007/s40266-017-0511-5