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

• Published in: Pharmacoepidemiology and drug safety 2019-06, Vol.28 (6), p.849-856
• Main Authors: Hamza, Sarah Ahmed, Adly, Nermien Naim, Abdelrahman, Ekramy Essa, Fouad, Ibrahim Mohamed
• Format: Article
• Language: English
• Subjects: Accidental Falls - prevention & control; Accidental Falls - statistics & numerical data; Aged; Aged, 80 and over; Antipsychotics; Assisted living facilities; Assisted Living Facilities - organization & administration; Assisted Living Facilities - standards; Assisted Living Facilities - statistics & numerical data; Cardiovascular Agents - adverse effects; Cardiovascular diseases; Case-Control Studies; Diuretics; Drug dosages; Drug Utilization Review - organization & administration; Drug Utilization Review - standards; Egypt; elderly; Falls; Female; Geriatric Assessment - statistics & numerical data; Geriatrics; Health risks; Humans; Hypnotics; Male; medications; Middle Aged; Narcotics; Nursing homes; Older people; Opioids; pharmacoepidemiology; Postural Balance - drug effects; Psychotropic drugs; Psychotropic Drugs - adverse effects; Risk Factors; Time and Motion Studies; TUGT; Vasodilators
• ISSN: 1053-8569; 1099-1557
• DOI: 10.1002/pds.4775

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 risk‐increasing 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.