Psychotropic drugs and the risk of fall injuries, hospitalisations and mortality among older adults.

ABSTRACT

OBJECTIVE: To investigate whether psychotropics are associated with an increased risk of fall injuries, hospitalizations, and mortality in a large general population of older adults. METHODS: We performed a nationwide matched (age, sex, and case event day) case-control study between 1 January and 31 December 2011 based on several Swedish registers (n = 1,288,875 persons aged ≥65 years). We used multivariate conditional logistic regression adjusted for education, number of inpatient days, Charlson co-morbidity index, dementia and number of other drugs. RESULTS: Antidepressants were the psychotropic most strongly related to fall injuries (ORadjusted 1.42; 95% CI 1.38-1.45) and antipsychotics to hospitalizations (ORadjusted 1.22; 95% CI 1.19-1.24) and death (ORadjusted 2.10; 95% CI 2.02-2.17). Number of psychotropics was associated with increased the risk of fall injuries, (4 psychotropics vs 0 ORadjusted 1.53; 95% CI 1.39-1.68), hospitalization (4 psychotropics vs 0 ORadjusted 1.27; 95% CI 1.22-1.33) and death (4 psychotropics vs 0 ORadjusted 2.50; 95% CI 2.33-2.69) in a dose-response manner. Among persons with dementia (n = 58,984), a dose-response relationship was found between number of psychotropics and mortality risk (4 psychotropics vs 0 ORadjusted 1.99; 95% CI 1.76-2.25). CONCLUSIONS: Our findings support a cautious prescribing of multiple psychotropic drugs to older patients. © 2016 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons, Ltd.