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Polypharmacy, benzodiazepines, and antidepressants, but not antipsychotics, are associated with increased falls risk in UK care home residents: a prospective multi-centre study

Izza, Madeline A. D.; Lunt, Eleanor; Gordon, Adam L; Gladman, John R F; Armstrong, Sarah; Logan, Phillipa A

Authors

Madeline A. D. Izza

Eleanor Lunt

ADAM GORDON Adam.Gordon@nottingham.ac.uk
Professor of The Care of Older People

JOHN GLADMAN john.gladman@nottingham.ac.uk
Professor of Medicine of Older People

PIP LOGAN pip.logan@nottingham.ac.uk
Professor of Rehabilitation Research



Abstract

Purpose: Falls and polypharmacy are both common in care home residents. Deprescribing of medications in residents with increased falls risk is encouraged. Psychotropic medications are known to increase falls risk in older adults. These drugs are often used in care home residents for depression, anxiety, and behavioural and psychological symptoms of dementia. However, few studies have explored the link between polypharmacy, psychotropic medications and falls risk in care home residents. Methods: A prospective cohort study of residents from 84 UK care homes. Data were collected from residents’ care records and medication administration records. Age, diagnoses, gender, number of medications and number of psychotropic medications were collected at baseline and residents were monitored over three months for occurrence of falls. Logistic regression models were used to assess the effect of multiple medications and psychotropic medication on falls whilst adjusting for confounders. Results: Of the 1,655 participants, mean age 85 (SD 8.9) years, 67.9% female, 519 (31%) fell in 3 months. Both the total number of regular drugs prescribed and taking ≥1 regular psychotropic medication were independent risk factors for falling (adjusted odds ratio (OR) 1.06 (95%CI 1.03-1.09, p

Citation

Izza, M. A. D., Lunt, E., Gordon, A. L., Gladman, J. R. F., Armstrong, S., & Logan, P. A. (2020). Polypharmacy, benzodiazepines, and antidepressants, but not antipsychotics, are associated with increased falls risk in UK care home residents: a prospective multi-centre study. European Geriatric Medicine, 11, 1043-1050. https://doi.org/10.1007/s41999-020-00376-1

Journal Article Type Article
Acceptance Date Jul 29, 2020
Online Publication Date Aug 19, 2020
Publication Date 2020-12
Deposit Date Jul 31, 2020
Publicly Available Date Aug 20, 2020
Journal European Geriatric Medicine
Print ISSN 1878-7649
Electronic ISSN 1878-7657
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 11
Pages 1043-1050
DOI https://doi.org/10.1007/s41999-020-00376-1
Keywords Residential Facilities; Accidental falls; Polypharmacy; Psychotropic Medications
Public URL https://nottingham-repository.worktribe.com/output/4798602
Publisher URL https://link.springer.com/article/10.1007/s41999-020-00376-1