World Health Matters: Medications linked to falls in older men

by Gary Finnegan: Ireland: Medicines routinely prescribed for older patients may be contributing to elevated rates of falls in elderly men, according to a study published in the Journal of the American Geriatrics Society.

Data from the Irish Longitudinal Study on Ageing (TILDA) revealed that falls causing injury were more than twice as likely in older men taking a particular group of commonly used medicines.

Many medicines which are commonly prescribed for older people for bladder problems, depression, psychosis, insomnia, and respiratory problems, have anti-cholinergic effects. The medications affect the brain by blocking a key chemical called acetylcholine which is involved in passing messages between nerve cells. This can lead to side effects including blurred vision, increased heart rate, sedation and confusion.

Previous studies have shown an impact on cognitive function and mortality from taking multiple anti-cholinergic medicines. The new study examined whether the use of such medicines increased the risk of subsequent serious falls (which caused injury) in people aged over 65 years.

Scientists from Trinity College Dublin, St James’s Hospital, Dublin, Ireland and three UK Universities have been pouring over the data from the TILDA study looking for links between medication use and subsequent falls.

The team found that falls resulting in injury were more than twice as likely in men taking medicines with potent anti-cholinergic activity. The effect remained even after accounting for differences in health and other risk factors for falls. A greater use of such medicines increased the risk for these men further. There was no such association for women, however.

Lead author Dr Kathryn Richardson said: “Our findings indicate the importance for doctors, pharmacists and healthcare professionals to regularly review the appropriateness of medications taken by their older patients.”

However, she stressed that people should not stop taking any medications before speaking with their doctor. “It is not fully clear why the same link was not found in women and further research is needed to explore this and the reasons behind the findings in men,” Dr Richardson said.

Senior author and Principal Investigator of TILDA Professor Rose Anne Kenny said falls can have a devastating impact on older people. “Falls are one of the leading causes of loss of independence as people get older and the principal reason given for admission into nursing home care in Europe. If early risk factors are identified and modified, falls can be prevented,” she said.