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Association of medication use with falls and mortality among long-term care residents: a longitudinal cohort study.
Roitto, Hanna-Maria; Aalto, Ulla L; Öhman, Hanna; Saarela, Riitta K T; Kautiainen, Hannu; Salminen, Karoliina; Pitkälä, Kaisu H.
Afiliação
  • Roitto HM; Department of Geriatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. hanna-maria.roitto@hel.fi.
  • Aalto UL; Finnish Institute for Health and Welfare, Population Health Unit, Helsinki, Finland. hanna-maria.roitto@hel.fi.
  • Öhman H; Department of Social Services and Health Care, Helsinki, Finland. hanna-maria.roitto@hel.fi.
  • Saarela RKT; Department of Geriatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
  • Kautiainen H; Department of Geriatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
  • Salminen K; Department of Social Services and Health Care, Helsinki, Finland.
  • Pitkälä KH; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.
BMC Geriatr ; 23(1): 375, 2023 06 19.
Article em En | MEDLINE | ID: mdl-37331981
ABSTRACT

BACKGROUND:

Falls in long-term care are common. The aim of our study was to explore how medication use is associated with incidence of falls, related consequences, and all-cause mortality among long-term care residents.

METHODS:

Five hundred thirty two long-term care residents aged 65 years or older participated in this longitudinal cohort study in 2018-2021. Data on medication use were retrieved from medical records. Polypharmacy was defined as use of 5-10 medications and excessive polypharmacy as use of > 10 medications. The numbers of falls, injuries, fractures, and hospitalizations were collected from medical records over 12 months following baseline assessment. Participants were followed for three years for mortality. All analysis were adjusted for age, sex, Charlson Comorbidity Index, Clinical dementia rating, and mobility.

RESULTS:

A total of 606 falls occurred during the follow-up. Falls increased significantly with the number of medications used. Fall rate was 0.84/person-years (pyrs) (95% CI 0.56 to 1.13) for the non-polypharmacy group, 1.13/pyrs (95% CI 1.01 to 1.26) for the polypharmacy group, and 1.84/pyrs (95% CI 1.60 to 2.09) for the excessive polypharmacy group. Incidence rate ratio for falls was 1.73 (95% CI 1.44 to 2.10) for opioids, 1.48 (95% CI 1.23 to 1.78) for anticholinergic medication, 0.93 (95% CI 0.70 to 1.25) for psychotropics, and 0.91 (95% CI 0.77 to 1.08) for Alzheimer medication. The three-year follow-up showed significant differences in mortality between the groups, the lowest survival rate (25%) being in the excessive polypharmacy group.

CONCLUSION:

Polypharmacy, opioid and anticholinergic medication use predicted incidence of falls in long-term care. The use of more than 10 medications predicted all-cause mortality. Special attention should be paid to both number and type of medications when prescribing in long-term care.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Acidentes por Quedas / Assistência de Longa Duração Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Acidentes por Quedas / Assistência de Longa Duração Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article