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. 2006 Feb;61(2):218-23.
doi: 10.1111/j.1365-2125.2005.02543.x.

Polypharmacy and falls in the middle age and elderly population

G Ziere  1 , J P Dieleman, A Hofman, H A P Pols, T J M van der Cammen, B H Ch Stricker
Affiliations

Polypharmacy and falls in the middle age and elderly population

G Ziere et al. Br J Clin Pharmacol. 2006 Feb.

Abstract

Aim: Falls in the elderly are common and often serious. We studied the association between multiple drug use (polypharmacy) and falls in the elderly.

Methods: This was a population-based cross-sectional study, part of the Rotterdam Study. The participants were 6928 individuals aged > or = 55 years. The prevalence of falls in the previous year was assessed. Medication use was determined with an interviewer-administered questionnaire with verification of use. Polypharmacy was defined as the use of four or more drugs per day.

Results: The prevalence of falls strongly increased with age. Falls were more common in women than in men. Fall risk increased with increasing disability, presence of joint complaints, use of a walking aid and fracture history. The risk of falling increased significantly with the number of drugs used per day (P for trend < 0.0001). After adjustment for a large number of comorbid conditions and disability, polypharmacy remained a significant risk factor for falling. Stratification for polypharmacy with or without at least one drug which is known to increase fall risk (notably CNS drugs and diuretics) disclosed that only polypharmacy with at least one risk drug was associated with an increased risk of falling.

Conclusions: Fall risk is associated with the use of polypharmacy, but only when at least one established fall risk-increasing drug was part of the daily regimen.

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Figures

Figure 1
Figure 1
Influence of the number of medications on falling adjusted for age & gender (p for trend <0.001)
Figure 2
Figure 2
Polypharmacy and use of drugs associated with falling. Users of medications (formula image), using one or more drugs associated with falling (formula image), proportion using one or more drugs associated with falling (•)
Figure 3
Figure 3
Influence of polypharmacy on falling, stratified on use of risk drugs
See this image and copyright information in PMC

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