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Use of non-benzodiazepine hypnotics is associated with falls in nursing home residents: a longitudinal cohort study

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Abstract

Background

Falls and related injuries are common among older people, and several drug classes are considered to increase fall risk.

Aims

This study aimed to investigate the association between the use of certain drug classes and falls in older nursing home residents in Sweden, and relate these to different age groups.

Methods

Information on falls that occurred in the previous year and regular use of possible fall risk drugs including non-benzodiazepine hypnotics (zopiclone and zolpidem) was collected from 331 nursing home residents during 2008–2011. Over the following 6 months, the occurrence of serious falls, requiring a physician visit or hospital care, was registered. Association between serious falls and drug use was compared between an older (≥ 85 years) and a younger group.

Results

An increased fall risk (Downton Fall Risk Index ≥ 3) was found in 93% of the study subjects (aged 65–101 years). Baseline data indicated an association between falls that occurred in the previous year and regular use of non-benzodiazepine hypnotics (p = 0.005), but not with the other studied drug classes. During the following 6 months, an association between use of non-benzodiazepine hypnotics and serious falls in the older group (p = 0.017, odds ratio 4.311) was found. No association was found between the other studied drug classes and serious falls.

Discussion

These results indicate an association between falls and the use of non-benzodiazepine hypnotics, compounds that previously have been considered generally well-tolerated in older people.

Conclusions

Caution is advocated when using non-benzodiazepine hypnotics regularly in older people living in nursing homes.

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Funding

SHADES was financially supported by the Medical Research Council of Southeast Sweden (FORSS) and Futurum—Academy of Health and Care, Region Jönköping County.

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Authors and Affiliations

  1. Department of Geriatrics, County Hospital Ryhov, Jönköping, Region Jönköping County, Sweden

    Björn Westerlind

  2. Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

    Björn Westerlind

  3. Department of Medical and Health Sciences, Linköping University, Linköping, Sweden

    Carl Johan Östgren & Staffan Hägg

  4. Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden

    Sigvard Mölstad & Patrik Midlöv

  5. Futurum, Jönköping, Region Jönköping County, Sweden

    Staffan Hägg

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  1. Björn Westerlind
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Corresponding author

Correspondence to Björn Westerlind.

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Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

Statement of human and animal rights

The SHADES study protocol was approved by the Regional Ethical Review Board, Linköping (nos.: M150-07 and 2016/67-32).

Informed consent

Written informed consent was obtained from all study subjects. For subjects with cognitive impairment who were unable to understand the information, the next of kin were consulted.

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Westerlind, B., Östgren, C.J., Mölstad, S. et al. Use of non-benzodiazepine hypnotics is associated with falls in nursing home residents: a longitudinal cohort study. Aging Clin Exp Res 31, 1087–1095 (2019). https://doi.org/10.1007/s40520-018-1056-0

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  • DOI: https://doi.org/10.1007/s40520-018-1056-0

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