Nearly all older people were prescribed a prescription drug that increased their risk of falling in 2017, according to a new UB study.
The study found that the percentage of adults aged 65 and over who had been prescribed a drug that increases the risk of falls jumped to 94% in 2017, a significant jump from 57% in 1999. The research found also revealed that the rate of deaths from falls in older adults more than doubled over the same period.
Even minor falls can be dangerous for the elderly. Falls that are not fatal can nonetheless lead to injuries, such as hip fractures and head trauma, which can significantly reduce the remaining quality of life. Each year, nearly $50 billion is spent on medical costs related to falls in older adults, according to the Centers for Disease Control and Prevention.
The alarming findings reinforce the importance of interventions to deprescribe potentially inappropriate medications in older and more frail patients, says Amy Shaver, principal investigator and postdoctoral associate in the School of Public Health and Health Professions.
“Our study indicates two trends increasing simultaneously at the population level that should be examined at the individual level. We hope this will start more conversations within healthcare teams about the pros and cons of medications being prescribed to vulnerable populations,” says Shaver.
Additional investigators from the School of Pharmacy and Pharmaceutical Sciences include Collin Clark, clinical assistant professor; David Jacobs, assistant professor; Robert Wahler Jr., associate clinical professor; and Mary Hejna, pharmacy resident at Kaleida Health.
Recently published in Pharmacoepidemiology and Drug Safety, the study examined data on deaths from falls and prescription fills in people aged 65 and older from the National Vital Statistics System and the Expenditure Panel Survey. medical.
Medications that increase the risk of falling include antidepressants, anticonvulsants, antipsychotics, antihypertensives (for high blood pressure), opioids, sedative-hypnotics, and benzodiazepines (tranquilizers such as Valium and Xanax), as well as other over-the-counter medications.
From 1999 to 2017, more than 7.8 billion orders for medications that increase the risk of falls were filled by seniors in the United States. The majority of prescriptions were for antihypertensives. However, the use of antidepressants has also risen sharply, from 12 million prescriptions in 1999 to over 52 million in 2017.
“The increase in antidepressant use observed 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 says. “However, it is important to note that these drugs are still associated with increased risks of falls and fractures in older people.”
Women were also more likely than men to be prescribed medications that increased fall risk, particularly black women, who received the medications at the highest rate compared to women of other races. White women ages 85 and older have seen the largest increase in deaths from falls, increasing 160% between 1999 and 2017.
Investigators are involved in multidisciplinary deprescribing initiatives led by the Alice team and the UB Center for Successful Aging. Efforts encourage and evaluate patient/caregiver-initiated deprescribing conversations with healthcare providers, promote interprofessional education on deprescribing, and advocate for policy and system change.
The research was funded in part by the National Cancer Institute.