Effects of central nervous system polypharmacy on falls liability in community-dwelling elderly.
Gerontology
; 44(4): 217-21, 1998.
Article
em En
| MEDLINE
| ID: mdl-9657082
ABSTRACT
BACKGROUND:
While central nervous system (CNS) active medications such as psychotropics and narcotic analgesics have been implicated in contributing to falls in older adults, the combined effect of multiple CNS-active medications has not been investigated. The purpose of this study was to examine the influence, in community-dwelling elderly, of (1) taking multiple CNS-active medications on fall liability and (2) individual classes of CNS-active medications (using discrete drug classification) on the risk of falls after controlling for important confounders--age, mobility, cognition and depression.METHODS:
305 community-dwelling male veterans (age 70-104) were screened at study entry for mobility, cognition and depression. CNS-active medications were categorized as benzodiazepines, other sedative-hypnotics, neuroleptics, tricyclic antidepressants, and opioid analgesics. Subjects were prospectively followed for 6 months to monitor falls; at the end of this time period, subjects were classified as fallers (at least one fall) or nonfallers. The relationship between CNS-active drug use and falls was examined using multivariable analyses.RESULTS:
The risk of falls was significantly greater in CNS-active medication users as compared with nonusers. Adjusted odds ratio for one CNS-active drug was 1.54 (95% confidence interval 1.07-2.22) and for two or more agents 2.37 (95% confidence interval 1.14-4.94).CONCLUSIONS:
In community-dwelling elderly, the use of multiple CNS-active medications is associated with enhanced falls liability, over and above the use of one CNS-active drug alone. This apparent dose-response relationship provides support for causality.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Acidentes por Quedas
/
Fármacos do Sistema Nervoso Central
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Aged
/
Humans
/
Male
Idioma:
En
Revista:
Gerontology
Ano de publicação:
1998
Tipo de documento:
Article
País de afiliação:
Estados Unidos