Psychotropic medications, including short acting benzodiazepines, strongly increase the frequency of falls in elderly

被引:54
作者
van Strien, Astrid M. [1 ]
Koek, Huiberdina L. [1 ]
van Marum, Rob J. [2 ]
Emmelot-Vonk, Marielle H. [1 ]
机构
[1] Univ Med Ctr, Dept Geriatr Med, NL-3508 GA Utrecht, Netherlands
[2] Jeroen Bosch Hosp, Dept Geriatr Med, Den Bosch, Netherlands
关键词
Psychotropic medications; Falls; Elderly; NURSING-HOME RESIDENTS; DOSE-RESPONSE RELATIONSHIP; MINI-MENTAL-STATE; OLDER-PEOPLE; RISK; DRUGS; METAANALYSIS; WITHDRAWAL; DEMENTIA; COHORT;
D O I
10.1016/j.maturitas.2013.01.004
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Objectives: Falls in the elderly are common and often serious. The aim of this study was to examine the association between the use of different classes of psychotropic medications, especially short acting benzodiazepines, and the frequency of falling in elderly. Study design This retrospective cohort study was performed with patients who visited the day clinic of the department of geriatric medicine of the University Medical Center Utrecht in the Netherlands between 1 January 2011 and 1 April 2012. Measurements Frequencies of falling in the past year and medication use were recorded. Logistic regression analysis was performed to assess the relationship between the frequency of falling in the past year and the use of psychotropic medications. Results: During this period 404 patients were included and 238 (58.9%) of them had experienced one or more falls in the past year. After multivariate adjustment, frequent falls remained significantly associated with exposure to psychotropic medications (odds ratio [OR] 1.96; 95% confidence interval [CI] 1.17-3.28), antipsychotics (OR 3.62; 95% CI 1.27-10.33), hypnotics and anxiolytics (OR 1.81; 95% CI 1.05-3.11), short-acting benzodiazepines or Z-drugs (OR 1.94; 95% CI 1.10-3.42) and antidepressants (OR 2.35; 95% CI 1.33-4.16). Conclusions: This study confirms that taking psychotropic medication, including short-acting benzodiazepines, strongly increases the frequency of falls in elderly. This relation should be explicitly recognized by doctors prescribing for older people, and by older people themselves. If possible such medication should be avoided for elderly patients especially with other risk factors for falling. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:357 / 362
页数:6
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