Adjusting Psychiatric Medication Dose May Reduce Falls in Elderly Patients

Psychiatric medication could increase fall risk among adults aged 65 and over.

Falls experienced by elderly patients can lead to hospitalization, broken bones, and other adverse events. Some falls are brought on by prescription drugs that may affect balance or perception.

A new study published by Social Science & Medicine suggests that adjusting the dose of psychiatric drugs could reduce the risk of falling in elderly patients.

The authors discovered that moderate increases in symptoms of depression were linked to a 30% increased risk of falling over the next 2 years. This link was found to be partly associated with an uptake of psychiatric drugs.

Although the study did not measure the impact of medication on falls, when the drugs were included in the model, the association between falls and depressive symptoms became nonsignificant, according to the authors.

"We've pinpointed that we think the relationship between depression and falls involves medication use with important implications for patient safety and fall risk reduction," said researcher Geoffrey Hoffman, PhD. "Many interventions to prevent falls are expensive and time-intensive, but this is a simple and inexpensive matter of encouraging continued use of psychiatric medication while improving monitoring of fall risk and adjusting medication appropriately."

Included in the study were patients aged 65 and older who were part of the National Health and Retirement Study, all of whom experienced a fall between 2006 and 2010.

The authors found that symptoms of depression preceded falls among elderly adults, but they did not discover that a fall was not followed by depression over the next 2 years, according to the study.

When looking at prescription drug use, the authors found that the link between depression symptoms and falls was weakened.

The authors recommend that older adults reduce the risk of experiencing a fall by remaining active and being cautious. Patients who feel symptoms of depression or have medication questions should consult a physician, according to the study.

The investigators recommend that family members and physicians monitor elderly patients for symptoms of depression. Specifically, physicians should choose and dose medications carefully, and also ask patients about fall risks.

Specialized geriatric societies should include depression and medication use in fall risk assessment protocols to ensure that health care professionals are aware of the risks, according to the study.

Falls cost approximately $30 billion per year, with up to half of patients entering a nursing home following the event. Adjusting psychiatric medication to prevent falls would also likely drive down spending.