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Laxatives as a Risk Factor for Iatrogenic Falls in Elderly Subjects

Myth or Reality?

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Abstract

Background The multifactorial nature of falls is well known, and several studies on falls in the elderly have reported that laxatives can be a risk factor, but without attempting to discuss possible mechanisms to explain this role.

Objective We aimed to isolate studies in which the risk factors for falls in the elderly related to laxatives have been evaluated and to carry out a meta-analysis combining the results of all identified good-quality studies.

Methods Systematic literature review using the keywords ‘accidental fall/numerical data’ and ‘risk factors’. This was followed by a manual search for articles cited in the previously identified publications. Articles were analysed if they had study populations aged ≥60 years, reported on falls occurring in everyday life, were observational or interventional studies that identified laxatives as a risk factor for falls, and were written in French or English. Articles of this type that were considered to be of good quality were included in the meta-analysis.

Results 3747 indexed articles published between 1981 and 2007 were identified. Of these, seven articles met all inclusion criteria and were analysed. The odds ratio (95% CI) for the association between use of laxatives and fall occurrence in subjects participating in the good-quality trials (n = 4) included in the meta-analysis was 2.03 (1.52, 2.72). This result was statistically homogeneous (percentage of the total variation across studies due to heterogeneity [I2] = 0).

ConclusionsElderly subjects treated with laxatives were twice as likely to fall compared with non-laxative users. The causal relationship was probably not directly attached to a side effect of the substance used, but rather a reflection of other pathologies (e.g. older age, confinement to bed, concomitant Parkinson’s disease) that may themselves cause falls.

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Acknowledgements

The authors would like to acknowledge the assistance of Caroline Tournoux-Facon from the Department of Epidemiology and Biostatistics of the University of Poitiers for the statistical analysis.

No sources of funding were used to assist in the preparation of this study. The authors have no conflicts of interest that are directly relevant to the content of this study.

F. Bloch had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Authors and Affiliations

  1. Department of Gerontology, Assistance Publique-Hôpitaux de Paris (Hôpital Broca), Paris, France

    Frédéric Bloch & Anne-Sophie Rigaud

  2. Laboratory of Exercise-Induced Physiological Adaptations, University of Poitiers, Poitiers, France

    Frédéric Bloch, Marie Thibaud, Benoit Dugué & Gilles Kemoun

  3. P’ Institute - UPR 3346, University of Poitiers, Poitiers, France

    Marie Thibaud & Cyril Brèque

  4. Fondation Hospitalière Sainte Marie, Paris, France

    Gilles Kemoun

Authors
  1. Frédéric Bloch
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  2. Marie Thibaud
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  3. Benoit Dugué
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  4. Cyril Brèque
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  5. Anne-Sophie Rigaud
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  6. Gilles Kemoun
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Correspondence to Frédéric Bloch.

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Bloch, F., Thibaud, M., Dugué, B. et al. Laxatives as a Risk Factor for Iatrogenic Falls in Elderly Subjects. Drugs Aging 27, 895–901 (2010). https://doi.org/10.2165/11584280-000000000-00000

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  • DOI: https://doi.org/10.2165/11584280-000000000-00000

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