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Drugs and falls in older people in geriatric care settings

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Abstract

Background and aims: Falls and their consequences constitute serious health problems in the older population. The aim was to study predisposing factors for falls among older people in geriatric care settings, focusing on drugs. Methods: This population-based study, with a cross-sectional design, analysed all geriatric care settings, comprising 68 residential care facilities, 31 nursing homes, 66 group dwellings for people with dementia, seven rehabilitation/short-stay units, two somatic geriatric and two psychogeriatric clinics, in the county of Västerbotten; 3604 residents with a mean age of 83.3±7.0 (65–103) years (68% women) were included. The residents were assessed by means of the Multi-Dimensional Dementia Assessment Scale (MDDAS) that measures, for example, mobility, paresis, vision, hearing, functions of activities of daily living (ADL), and behavioural and psychiatric symptoms. Drug consumption and falls during the previous week were recorded. Results: Three hundred and one residents (8.4%) had sustained a fall at least once during the preceding week. Multivariate analyses showed that a history of falls, the ability to get up from a chair, the need for a helper when walking, pain, cognitive impairment, and use of neuroleptics or antidepressants were all associated with being a faller. Among the antidepressants, selective serotonin reuptake inhibitors (SSRIs) but not serotonin and noradrenalin reuptake inhibitors (SNRIs) were associated with falls. Cholinesterase inhibitors were not associated with falls. Conclusions: Like functional and cognitive impairment, treatments with antidepressants and neuroleptics are predisposing factors for falls in older people in residential care. However, there seem to be differences between subgroups among these drugs and, from the perspective of fall prevention, SNRIs rather than SSRIs should perhaps be preferred in the treatment of depression in older people.

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Authors and Affiliations

  1. Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, SE-901 87, Umeå, Sweden

    Kristina Kallin MD, Yngve Gustafson & Stig Karlsson

  2. Department of Nursing, Umeå University, Umeå, Sweden

    Per-Olof Sandman

Authors
  1. Kristina Kallin MD
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  2. Yngve Gustafson
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  3. Per-Olof Sandman
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  4. Stig Karlsson
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Correspondence to Kristina Kallin MD.

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Kallin, K., Gustafson, Y., Sandman, PO. et al. Drugs and falls in older people in geriatric care settings. Aging Clin Exp Res 16, 270–276 (2004). https://doi.org/10.1007/BF03324551

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