Study: Most Older Adults Prescribed Drugs That Increase Fall Risk

March 18, 2021
Aislinn Antrim, Associate Editor

The study results reiterate the importance of interventions to lower prescribing rates of potentially inappropriate drugs among older adults.

A new study has found that the vast majority of older adults are prescribed drugs that increase their risk of falling, a cause of death that has sharply increased in recent decades.

The percentage of adults 65 years of age and older who were prescribed a fall risk-increasing drug increased to 94% in 2017, a significant increase from 57% in 1999, according to the study. Notably, the researchers said that the rate of death caused by falls in this patient population more than doubled during the same time period.

Even minor falls can be dangerous for older adults and can result in injuries that may drastically impact their remaining quality of life. Each year, the investigators said nearly $50 billion is spent on medical costs related to fall injuries among older adults. The findings reiterate the importance of interventions to lower prescribing rates of potentially inappropriate drugs among older adults, according to the study authors.

“Our study indicates 2 trends increasing concurrently at a population level that should be examined at the individual level,” said lead investigator Amy Shaver, PharmD, in the press release. “Our hope is it will start more conversations on health care teams about the pros and cons of medications prescribed for vulnerable populations.”

The investigators used data on deaths due to falls and prescription fills among people 65 years of age and older from the National Vital Statistics System and the Medical Expenditure Panel Survey. Many classes of drugs can increase older adults’ risk of falling, although these drugs are often necessary in this population.

They include antidepressant drugs, anticonvulsant drugs, antipsychotic drugs, antihypertensive medications, opioids, sedative hypnotics, and benzodiazepines, according to the study. Other nonprescription medications can also increase fall risks.

Between 1999 and 2017, more than 7.8 billion fall risk-increasing drug orders were filled by older adults in the United States. According to the investigators, the majority of these were for antihypertensives, although there was also a sharp rise in the use of antidepressants, from 12 million prescriptions in 1999 to more than 52 million in 2017.

“The rise in the use of antidepressant medications seen in this study is likely related to the use of these agents as safer alternatives to older medications for conditions such as depression and anxiety,” Shaver said in the press release. “However, it is important to note that these medications are still associated with increased risks of falls and fractures among older adults.”

The investigators also noted that women were more likely than men to be prescribed fall risk-increasing drugs, particularly Black women, who received the medications at the highest rate compared to women of other races. White women who were 85 years of age and older experienced the largest increase in deaths from falls, rising 160% between 1999 and 2017.

REFERENCE

94% of older adults prescribed drugs that raise risk of falling [news release]. University at Buffalo; March 15, 2021. http://www.buffalo.edu/news/releases/2021/03/014.html. Accessed March 16, 2021.