[Prognostic value of psychotropic drugs for the risk of accidental falls]. / Valore prognostico dei farmaci psicotropi nel rischio caduta.

ABSTRACT

Falls in the elderly are common and often serious. Older adults often take numerous medications for multiple chronic conditions, so they have an increased risk for drugs that potentially cause falls. We studied the association between psychotropic drugs and falls in residential care people in order to identify medications that may increase the falls risk. A prospective case control study was performed in the nursing home of Local Health Care. We assessed the incidence of patient falls during admission in nursing home in 2007 and 2008. We compared psychotropic medications (antipsychotic drugs N05B, anxiolytics N05B, antidepressants NO6A, anticholinesterases NO6D) taken by all patients who fell (140 cases) with those taken by patients who did not fall (140 controls), paired with an allocation ratio of 11 for the same age (quinquennial classes), sex, time of admission to nursing home. The probability of falls increased when the patients used antipsychotic drugs (OR 1.91; 95% CI 0.47, 0.19; p = 0.0114) and when the number of psychotropic drugs is equal to or greater than 2 the risk of falling increases more. (OR 2.3; 95% CI 0.56, 0.18;p = 0.0036). This work reinforces the importance of routine medication reviews, especially in elderly exposed to psychotropic polypharmacy regimens that include antipsychotic drugs.