Falls are a major concern for older adults, senior living providers, and many other aging services providers. A recent study shows that a class of drugs used to treat a variety of conditions that, on the surface aren’t related to mobility, turns out increase a risk of injurious falls for some older adults.
Many older adults take medications that are classified as anticholinergic, for a variety of medical conditions, including incontinence, depression, and psychosis. Moreover, as older adults’ bodies change with age, they become more susceptible to the effects of anticholinergic drugs. This class of medicines has previously been associated with some cognitive and functional decline in older adults, and a recent study looked at the potential impact of these medications on falls.
This study looked at a sample of 2,696 community-dwelling older adults who were taking part in the Irish Longitudinal Study on Aging. The researchers tracked prescription drug usage for participants as well as the incidence of falls for the participants over a two-year period.
Over the period studied, 26 percent of the participants reported experiencing a fall, with a total of 1,474 falls reported, and 344 participants reported having a fall that resulted in an injury. Falls more common among women than men.
For men in the study, use of anticholinergic medications was associated with a higher risk of falls that resulted in injury. There was also a significant association of medication dosage and risk of injurious falls observed in men. This finding held up when the researchers adjusted for the possible influence of factors like gait and grip strength on falls risk. Interestingly, the use of anticholinergic medications did not impact the risk of falls in general, only injurious falls.
For women, the same association of anticholinergic medication and falls leading to injury was not observed. At present, it is not clear why the increased falls risk was only observed in men. The study’s authors suggest that one potential contributing factor could be that males and females are likely to have different types of falls that lead to injury.
The association observed here between anticholinergic medications and falls leading to injury for men suggests that older adults, physicians, nurses, senior living service providers, and caregivers should be made aware of the risk associated with such medications. The conditions that anticholinergic medications target are often not ones associated with falls risk. In the case of individuals who may exhibit other risk factors for falls, attention should be paid to anticholinergic drug use, and discussions should be had about whether lower dosages would be appropriate or whether alternative drugs without anticholinergic properties should be prescribed instead.
Richardson K, Bennett K, Maidment, ID, et al. Use of medications with anticholinergic activity and self-reported injurious falls in older community-dwelling adults. Journal of the American Geriatrics Society. (2015). DOI: 10.1111/jgs.13543