Document Detail


Number and dosage of central nervous system medications on recurrent falls in community elders: the Health, Aging and Body Composition study.
MedLine Citation:
PMID:  19196642     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Few studies have examined the risk of multiple or high doses of combined central nervous system (CNS) medication use for recurrent falls in the elderly. The study objective was to evaluate whether multiple- or high-dose CNS medication use in older adults was associated with a higher risk of recurrent (>or=2) falls.
METHODS: This longitudinal cohort study included 3,055 participants from the Health, Aging and Body Composition study who were well functioning at baseline. CNS medication use (benzodiazepine and opioid receptor agonists, antipsychotics, antidepressants) was determined annually (except Year 4) during in-person interviews. The number and summated standard daily doses (SDDs; low, medium, and high) of CNS medications were computed. Falls 1 year later were ascertained annually for 5 years.
RESULTS: For a period of 5 years, as many as 24.1% of CNS medication users took 2+ agents annually, whereas as no more than 18.9% of CNS medication users took high doses annually (3+ SDDs). Yearly, as many as 9.7% of participants reported recurrent falls. Multivariable Generalized Estimating Equation analyses showed that multiple CNS medication users compared with never users had an increased risk of sustaining 2+ falls (adjusted odds ratio [OR] 1.95; 95% confidence interval [CI] 1.35-2.81). Those taking high (3+) CNS SDDs also exhibited an increased risk of 2+ falls (adjusted OR 2.89; 95% CI 1.96-4.25).
CONCLUSIONS: Higher total daily doses of CNS medications were associated with recurrent falls. Further studies are needed to determine the impact of reducing the number of CNS medications and/or dosage on recurrent falls.
Authors:
Joseph T Hanlon; Robert M Boudreau; Yazan F Roumani; Anne B Newman; Christine M Ruby; Rollin M Wright; Sarah N Hilmer; Ronald I Shorr; Douglas C Bauer; Eleanor M Simonsick; Stephanie A Studenski
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, N.I.H., Intramural     Date:  2009-02-04
Journal Detail:
Title:  The journals of gerontology. Series A, Biological sciences and medical sciences     Volume:  64     ISSN:  1758-535X     ISO Abbreviation:  J. Gerontol. A Biol. Sci. Med. Sci.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-18     Completed Date:  2009-04-21     Revised Date:  2011-05-04    
Medline Journal Info:
Nlm Unique ID:  9502837     Medline TA:  J Gerontol A Biol Sci Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  492-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Geriatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA. hanlonj@dom.pitt.edu
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MeSH Terms
Descriptor/Qualifier:
Accidental Falls / prevention & control,  statistics & numerical data*
Aged
Aging / drug effects*,  physiology
Antidepressive Agents / adverse effects,  therapeutic use
Antipsychotic Agents / adverse effects,  therapeutic use
Benzodiazepines / adverse effects,  therapeutic use
Body Composition
Central Nervous System Agents / adverse effects*,  therapeutic use
Cohort Studies
Confidence Intervals
Dose-Response Relationship, Drug
Drug Utilization
Female
Geriatric Assessment
Health Status
Humans
Incidence
Longitudinal Studies
Male
Odds Ratio
Prognosis
Recurrence
Residence Characteristics
Risk Assessment
Grant Support
ID/Acronym/Agency:
N01 AG062101/AG/NIA NIH HHS; N01-AG-6-2101/AG/NIA NIH HHS; N01-AG-6-2103/AG/NIA NIH HHS; N01-AG-6-2106/AG/NIA NIH HHS; P30 AG024827-05/AG/NIA NIH HHS; P30AG024827/AG/NIA NIH HHS; R01 AG027017-03/AG/NIA NIH HHS; R01AG027017/AG/NIA NIH HHS
Chemical
Reg. No./Substance:
0/Antidepressive Agents; 0/Antipsychotic Agents; 0/Central Nervous System Agents; 12794-10-4/Benzodiazepines
Comments/Corrections

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