The older you get, the higher the probability that you take a prescription drug, or several. What’s supposed to help you, however, can pose a risk – half of the 20 most prescribed medications taken by older people might increase the risk of a fall. And falls in older people can be deadly.
According to a study published in the European Journal of Public Health, antidepressants and drugs taken to control pain were most strongly associated with a greater probability of being injured in a fall. Serious injuries were significantly more common with 11 of the 20 medications studied.
The researchers studied prescription drug data on nearly 7 million Swedes older than 65. They counted the number of falls among people taking any of the 20 medications most commonly prescribed to seniors in Sweden, and identified 64,399 cases of such injuries that led to hospitalization.
The researchers acknowledged that some added risk could result from the conditions the drugs are prescribed to treat. But because the older population is large and growing, they say any association of medication and fall injuries must be considered by doctors. We would add our usual advice: When your doctor prescribes a medication, always ask:
- Why is this the best treatment?
- What will happen if I don’t take it?
- Are there alternatives and/or a generic version?
- When can I expect to see results?
- What are the side effects, and how likely am I to experience them?
- What are the risks?
- Are there foods or other medicines I should avoid when taking this medicine?
Although this was a European study, more than 40 million people in the U.S. are over 65 years old, as noted on Reuters.com, and 1 in 3 of them take eight or more medications daily, according to the National Center for Biotechnology Information.
“Falls are a leading cause of disability and death among seniors,” Reuters reported, “and researchers increasingly suspect that prescription medications play an important role in fall injuries.”
The Swedish study found that men and women taking opioid painkillers as well as men taking antidepressants were more than twice as likely to have a fall injury as those who weren’t taking those drugs. Women taking antidepressants were 75% more likely to have a fall injury.
Drugs for ulcers and GERD (gastroesophageal reflux disease, for which drugs that suppress stomach acid are prescribed), calcium, vitamin B12 and some nonopioid painkillers also were linked to as much as a 75% percent greater risk of fall injuries. Heart medications, generally, were not linked to fall risk.
As Reuters pointed out, “The study cannot prove that medications caused falls in all cases, and for drugs that have not previously been linked to fall injuries – including anticlotting agents, drugs for peptic ulcers and vitamin B12 – the researchers think the underlying conditions the drugs are prescribed to treat may be to blame.”
Telling the difference between a fall resulting from a disorder and one caused by medication can be difficult. Dr. Johan Fastbom, a professor at the Aging Research Center at the Karolinska Institute told Reuters that people should “[pay] attention to other symptoms caused by the drugs.” They include vertigo, dizziness, drowsiness, psychomotor impairment, muscular weakness and cognitive impairment.
Anyone who takes medication and experiences any or several of these symptoms should discuss with their doctor if the risk is greater than the benefit.
Further studies probably will examine how different doses of these medications affect both treatment outcome and fall risk. Doses often vary considerably and often are different for men and women.
Researchers also probably will study potential interactions among medications, including those taken over the counter.