Polypharmacy and falls in the middle age and elderly population

• Published in: British journal of clinical pharmacology Vol. 61; no. 2; pp. 218 - 223
• Main Authors: Ziere, G., Dieleman, J. P., Hofman, A., Pols, H A. P., Van Der Cammen, T. J. M., Stricker, B. H. CH
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01-02-2006; Blackwell Science; Blackwell Science Inc
• Subjects: Accidental Falls - statistics & numerical data; Age Factors; Aged; Aged, 80 and over; Biological and medical sciences; Drug-Related Side Effects and Adverse Reactions; elderly; Epidemiologic Methods; falls; Female; geriatric medicine; Humans; Male; Medical sciences; Middle Aged; Netherlands - epidemiology; Pharmacoepidemiology; Pharmacology. Drug treatments; pharmaco‐epidemiology; Polypharmacy; risk drugs; Sex Factors; Netherlands; Human; Drug; Drug combination; Middle age; pharmaco-epidemiology; Epidemiology; Medicine; falls; geriatric medicine; Risk factor; risk drugs; Elderly; Public health; polypharmacy; Geriatrics
• ISSN: 0306-5251; 1365-2125
• DOI: 10.1111/j.1365-2125.2005.02543.x

Aim
Falls in the elderly are common and often serious. We studied the association between multiple drug use (polypharmacy) and falls in the elderly.
Methods
This was a population‐based cross‐sectional study, part of the Rotterdam Study. The participants were 6928 individuals aged ≥ 55 years. The prevalence of falls in the previous year was assessed. Medication use was determined with an interviewer‐administered questionnaire with verification of use. Polypharmacy was defined as the use of four or more drugs per day.
Results
The prevalence of falls strongly increased with age. Falls were more common in women than in men. Fall risk increased with increasing disability, presence of joint complaints, use of a walking aid and fracture history. The risk of falling increased significantly with the number of drugs used per day (P for trend < 0.0001). After adjustment for a large number of comorbid conditions and disability, polypharmacy remained a significant risk factor for falling. Stratification for polypharmacy with or without at least one drug which is known to increase fall risk (notably CNS drugs and diuretics) disclosed that only polypharmacy with at least one risk drug was associated with an increased risk of falling.
Conclusions
Fall risk is associated with the use of polypharmacy, but only when at least one established fall risk‐increasing drug was part of the daily regimen.