Aim
Polypharmacy is prevalent among older adults and has been mainly reported to be associated with falls among community‐dwelling or nursing home residents. Our study aimed to investigate the relationship between polypharmacy and falls among older Chinese hospitalized patients.
Methods
A nationwide prospective cohort study included 9062 participants in six hospitals from China aged ≥65 years, with a 1‐year follow‐up period. Baseline polypharmacy and other health‐related variables were collected when older inpatients were recruited on hospital admission. Polypharmacy was defined as patients who have taken five medications or more. Well‐trained nurses assessed falls by telephone at follow up. We used multivariate logistic regression analysis to examine the association between polypharmacy and the risk of falls based on cross‐sectional analyses and longitudinal analyses.
Results
Of 9062 participants, the mean age was 72.42 years (SD= 5.69), and 5228 (57.69%) were men. After fully adjusted for age, sex, education, depression, cognitive impairment, low handgrip strength, frailty, various hospitals, and nutritional status, the cross‐sectional and longitudinal analyses showed that inpatients with polypharmacy had an increased risk of falls (OR 1.37, 95%CI 1.17–1.56 for the cross‐sectional association; OR 1.43, 95% CI 1.01–2.03 for the longitudinal association, respectively), compared with those without polypharmacy. In addition, subgroup analyses of the association between polypharmacy and 1‐year falls, or history of falls was unchanged.
Conclusions
Polypharmacy was prevalent among older Chinese hospitalized patients and was an independent risk factor of 1‐year falls, suggesting that clinicians should make a comprehensive assessment of medications, and deprescribing strategies should be implemented to reduce unnecessary medications for decreasing the rate of falls. Geriatr Gerontol Int 2021; 21: 810–817.