One Half of Commonly Prescribed Medications Increase Falls Among the Elderly
The European Journal of Public Health has found some important news: Many medications prescribed to the elderly may potentially lead to more harm due to falls, which subsequently can lead to certain life-threatening injuries. It was found that one-half of the 20 most commonly prescribed medications that are used frequently among the older adult population increase the risk of falls. This is very sobering news since many of these medications may be needed for other health related conditions, yet the cost may be falls that could in fact lead to more serious issues than the initial conditions that the medication was prescribed for.
Among the most serious medications that contributed to the increased fall risk were painkilling medications and antidepressants as well as sedatives and hypnotic agents used for sleep. All of these medications have an impact upon the central nervous system. They can cause grogginess, lethargy, a lack of coordination, and a clouding of one's consciousness, all of which may greatly increase an older adult's likelihood of falls.
The researchers analyzed data on nearly seven million Swedish elderly and they found 64,399 cases of falls that lead to hospitalizations that were contributed to by the use of medications that had fall-inducing effects. The researchers found that those that were taking opioid and antidepressant medications had more than twice the likelihood of experiencing an injury due to a fall as compared to those that did not take these medications. Opioids are powerful pain killing medications, such as codeine, morphine or Vicodin just to name a few. They are opiate or opiate derivatives that have can not only have a pronounced pain killing effect, but they also can have a powerful effect on a person's consciousness as well as well as leading to an unsteady gait. Antidepressant medications, prescribed for depression or anxiety, often can lead to anxiety or feeling jittery, lightheadedness, and an unsteady gait. These are just a few of the common side-effects that can be found among these medications. Furthermore, the likelihood for these side-effects, all of which can lead to greater likelihoods for falls, increases with age. Although older adult males and females who took opioid medications appeared to be equally likely to experience adverse side-effects leading to falls, older women who took antidepressants had approximately 75 percent greater likelihood of falls.
There were some surprising medications that appeared to be correlated with an increased risk for falls. Medications used to treat GERD, calcium, often used for bone health supplementation, Vitamin B12, frequently given at higher doses by way of injection by physicians, and certain non-opioid pain killing medications demonstrated an increased risk of falls that ranged from 15% to 75%. Diuretics, often referred to more colloquially as water pills and frequently prescribed for edema due to congestive heart disease also was found to increase the probability of falls
It must be stated however that these were correlational findings. In other words, this was not a cause-effect finding. It is often very difficult to differentiate between the falls being due to the affects of the medications or due to the underlying medical conditions of the elderly. However, as one physician stated, one needs to pay attention to symptoms caused by many drugs that can potentially lead to falls. Individuals, including the older adult's physician, have to be vigilant for such things as vertigo, drowsiness, motor movement impairment, muscular weakness and cognitive impairment.
The likelihood for experiencing side-effects that may cause falls does not in itself mean that these medications are not justified for use in the elderly. What it does state is that the physician needs to always consider weighing the fall risk that is incurred versus the therapeutic value that the medication may have for helping the quality of life of the older adult.
Older adult's become more sensitive to the side-effects of almost all medications as they age. The medication's dosage levels are often not determined based on different adult age group variations. This in itself is problematic since different ages, based on changes in the biological organism's structure and function as we age also alter the pharmacokinetic effects of medications. Therefore, given this, one needs to make sure that individuals are judiciously followed and evaluated for adverse effects that may potentially lead to falls and offset any therapeutic value of using the drug.
Kennedy, M. (2014/Aug). Many Meds Taken by Seniors Can Raise Risk of Falls. Medscape. http://www.medscape.com/viewarticle/829826?src=wnl_edit_medn_wir&uac=87637DR&spon=34