Trends in fall‐related mortality and fall risk increasing drugs among older individuals in the United States,1999–2017

Abstract

Background: Previous studies have demonstrated increasing mortality due to falls among older adults. The objective of this study was to determine whether there was an increase in fall risk increasing drug prescribing and if this is concurrent with an increase in fall-related mortality in persons 65 years and older in the United States. Methods:The study is a serial cross-sectional analysis utilizing data from both the National Vital Statistics System (NVSS) and the medical expenditure panel survey (MEPS) for years 1999-2017. Adults aged 65 years and older were evaluated for death due to falls from the NVSS and for prescription fills of fall risk increasing drugs per the Stopping Elderly Accidents, Deaths, and Injuries-Rx (STEADI-Rx) fall checklist from the MEPS.Results: The analysis included 374 972 fall-related mortalities and 7 858 177 122 fills of fall risk increasing drugs. 563 037 964 persons age 65 and older received at least one fall risk increasing drug. Age-adjusted mortality due to falls increased from 29.40 per 100 000 in 1999 to 63.27 per 100 000 in 2017. The percent of persons who received at least one prescription for a fall risk increasing drug increased from 57% in 1999 to 94% in 2017 (p for trend <.0001).Conclusions and relevance: Both use of fall risk increasing drugs and mortality due to falls are on the rise. Fall risk increasing drugs may partially explain the increase in mortality due to falls; this cannot be firmly concluded from the current study. Future research examining the potential relationship between fall risk increasing drugs and fall-related mortality utilizing nationally representative person-level data are needed.

One-Legged Balance Performance and Fall Risk in Mid and Later Life: Longitudinal Evidence From a British Birth Cohort

“…These increases persist in age-adjusted analyses, indicating that this rise is not attributable to population aging alone. 12,13 Pooled data from Great Britain, Ireland, Australia, and The Netherlands indicate that fall prevalence rises during midlife from 8.7% (age 43 years) to 20.9% (age 50−54 years) to 29.9% (age 60−64 years) in women, with similar increases in men. 14 Despite meaningful fall prevalence in midlife, there is minimal evidence examining the risk factors for falls in middle-aged adults.…”

Co-prescribing of opioids and benzodiazepines/Z-drugs associated with all-cause mortality—A population-based longitudinal study in primary care with weak opioids most commonly prescribed

“…This could be relevant in the case of opioids where respiratory depression is a well-known side effect often with serious consequences. The use of psychotropic drugs can lead to increased risk of falls and fractures ( Waade et al, 2017 ; Ohara et al, 2021 ) and as a consequence increased mortality in the elderly ( Shaver et al, 2021 ). Increased suicide risk has been reported ( Cato et al, 2019 ) as well as risk of traffic accidents ( Booth et al, 2016 ).…”

A systematic review of chiropractic care for fall prevention: rationale, state of the evidence, and recommendations for future research

“…The prevalence of falls and mobility limitations increase with age with most older adults experiencing these by age 85 [2][3][4][5]. Among community-living older adults, falls are the leading cause of serious injury, disability, nursing home placement, and injury-related death [6][7][8][9]. Fatal falls in older persons exceed the death rate from the opioid epidemic by a factor of four [10,11].…”