Number and Dosage of Central Nervous System Medications on Recurrent Falls in Community Elders: The Health, Aging and Body Composition Study

Abstract

Higher total daily doses of CNS medications were associated with recurrent falls. Further studies are needed to determine the impact of reducing the number of CNS medications and/or dosage on recurrent falls.

Falls Risk in Older Adults with Type 2 Diabetes

“…In addition to the general physiologic changes often seen with increasing age and disease, the high incidence of polypharmacy (ie, 4 or more medications) 56 (also see the article by Peron and colleagues elsewhere in this issue) is another major risk factor for falls, [57][58][59] one that needs to be addressed to lower the risk. Research has shown that a simple reduction of psychotropic medications and polypharmacy can result in a significantly reduced fall rate.…”

“…Similarly, reduction of psychotropic medications and polypharmacy has been shown to also result in a reduced fall rate. 8,20,57,65,66 Depression is another cognitive factor commonly associated with falls and diabetes because of increased activity avoidance and the prescription of psychotropic medications to treat this disorder. 8,20,57,59 Furthermore, the delicacy of electrolyte balance in older people and the use of diuretics and other drugs causing hyponatremia (serum sodium <135 mmol/L) are increasingly recognized as risk factors.…”

A simple tool predicted probability of falling after aged care inpatient rehabilitation

“…The association between medication targeting the CNS and falls has been established by studies in hospitals, residential aged care, and the community [26,27]. Some community studies [28] have found women to be more likely to fall Excluded (n = 785) Readmission (already in study) (n = 55) Left ward before screening (n = 67) Cognitive impairment and no "person responsible" available to give consent (n = 106) Refused to participate (n = 195) Not screened due to staff leave (n= 143) Too medically unwell or otherwise unable to carry out the assessment (n = 128) Pre-discharge assessment not completed due to patient or/staff timetables (n = 91)…”

Effects of drug pharmacokinetic/pharmacodynamic properties, characteristics of medication use, and relevant pharmacological interventions on fall risk in elderly patients

“…Fall risk increased significantly with 28% at 0.25 of the defined daily dose (DDD) of an antipsychotic or antidepressant, with 8% at 0.2 of the DDD of an anxiolytic, and with 56% at 0.5 of the DDD of a hypnotic or sedative; it increased further with dose increases and with combinations of psychotropics. 43 Hanlon 44 A population-based cohort study by Coupland et al showed significant association of falls in elderly patients with depression (P,0.01) with doses of tricyclic antidepressants (TCAs) and selective serotonin-reuptake inhibitors (SSRIs). 45 Sano et al observed an increased risk of falls in hospitalized psychiatric patients taking doses of chlorpromazine equivalents $600 mg (OR 3.75, 95% CI 2.41-5.83; P,0.05) or doses of diazepam equivalents $15 mg (OR 2.08, 95% CI 1.45-2.98; P,0.05).…”