Medicatie gerelateerd aan vaak vallen bij ouderen*

Objective

To investigate which medications are associated with recurrent falls in elderly patients who attend the accident and emergency department following a fall.

Design

Cross-sectional study.

Method

Patients aged ≥ 65 years who attended the accident and emergency department between 2004 and 2010 following a fall, were invited to fill in a validated fall-questionnaire designed to assess the risk of falling accidents. We divided self-reported medications into anatomic therapeutic chemical (ATC) classes. Univariate logistic regression analysis was performed to explore the association between ATC medication classes and recurrent falls. Multivariate logistic regression analysis was used to assess the associations after adjustment for potential confounders.

Results

In total, 2258 patients participated in our study, of whom 39% (873) had sustained ≥ 2 falls within the previous year. After adjustment for potential confounders, the following medications appeared to be significantly more frequently associated with recurrent falls than with single fall incidents: antacids (adjusted odds ratio (aOR): 1.29; 95% CI: 1.03-1.60); analgesics (aOR: 1.22; CI: 1.06-1.41); anti-Parkinson medication (aOR: 1.59; CI: 1.02-2.46); nasal preparations (aOR: 1.49; CI: 1.07-2.08); ophthalmological medications (aOR: 1.51; CI: 1.10-2.09); antipsychotics (aOR: 2.21; CI: 1.08-4.52); and antidepressants (aOR: 1.64; CI: 1.13-2.37).

Conclusion

Medications known to increase the risk of falls, such as psychotropic drugs, anti-Parkinson medications and analgesics, increase the risk of recurrent falls. Additionally, we found 4 other drug classes that showed significant association with recurrent falls. It could be that the use of medications from these classes is an indication of frailty and comorbidity in the elderly in general, or they may reflect a difference in the risk-profile between recurrent and single fallers. Further investigation is required to achieve improved insight into the causes and mechanisms associated with medication-related recurrent falls in the elderly.

Conflict of interest: none declared. Financial support: this study was funded by the Netherlands Institute for Health Research and Development (ZonMw), project number 300020010.