Prescription medication use linked to falls in younger adults
MedWire News: Polypharmacy appears to be a risk factor for falls in younger and middle-aged individuals, research suggests.
The findings mirror the well-established link between prescription medication use and unintentional falls in elderly people, say Bridget Kool (University of Auckland, New Zealand) and co-authors writing in Injury Prevention.
Kool et al used data from a population-based case-control study to analyze the link between use of medication and falls.
The 335 cases were individuals aged 25-60 years who died or were admitted to hospitals in the Auckland region between July 2005 and July 2006 within 48 hours of an unintentional fall-related injury at home.
The Prevention of Falls Network Europe (ProFaNE) definition of fall was used: "An unexpected event in which the person comes to rest on the ground, floor, or lower level."
These individuals were compared with 352 age- and gender-matched people selected at random from the local electoral roll.
The cases were interviewed at hospital or at home while controls were interviewed by telephone. In all instances, the interview was conducted by a trained investigator using a structured questionnaire.
Kool's team found that a significantly higher proportion of cases than controls was taking prescription medications, at 40.3% versus 29.8%.
While the proportion of people taking one or two prescription medications was similar between cases and controls, a significantly higher proportion of cases was taking three or four prescription medications (6.6 vs 2.8%) and five or more medications (6.9% vs 2.6%).
Sociodemographic factors and general health status did not differ between cases and controls. However, cases were more likely than controls to report acute marijuana use (3.1 vs 0.9%).
In a multivariate model that adjusted for age, gender, ethnicity, paid employment, and socioeconomic status, use of two or more prescription medications was associated with a 2.57-fold increased risk for falls compared with use of one or no prescription drugs.
In a model that adjusted further for smoking, acute marijuana use, acute alcohol use, sleep in the previous 24 hours, and physical activity, the odds ratio (OR) changed marginally to 2.46.
Finally, of the six groups of medication that had sufficient numbers for analysis, antihypertensives and lipid-lowering drugs were associated with an increased risk for falls (OR=3.1 and OR=2.5, respectively) whereas there was no association with bronchodilators, anti-inflammatories, corticosteroids, or psychotropic drugs.
"The findings of this study indicate the need for more focused research that can disaggregate the effect of drugs relative to underlying conditions, as well as examine the effects of specific drugs, dosages, and their possible interactions," write Kool et al.
"In addition, the relationships between patterns of medication use and the severity of fall-related injuries, or the inter-relationships between factors such as alcohol use, fatigue, sleepiness or shift work are worthy of exploration."
By Joanna Lyford