Medications and fall risk: a case-control study in nursing home residents in Japan

Aging Clin Exp Res. 2020 May;32(5):885-892. doi: 10.1007/s40520-019-01265-9. Epub 2019 Jul 17.

Abstract

Aim: Falls are a significant problem for older people, but are few studies of the risk of falling in residents of nursing homes in Japan. We aimed to investigate the risk factors for falls and the association of medication use and falls in nursing home residents in Japan.

Methods: This case-control study reviewed the records of residents of who were ≥ 65 years of age and had fallen in 2012 and an age-, sex-, and facility-matched control group selected from 58 nursing homes in Japan. The odds ratios of potential risk factors and current medications were determined by conditional logistic regression.

Results: A total of 1832 residents (916 cases and 916 controls) were included. Falls were significantly associated with an inability to walk without assistance or stand up without assistance, need for toileting assistance, visual impairment, insomnia, and dementia. Current prescription of antithrombotic, nonsteroidal anti-inflammatory, or antiparkinson drugs, muscle relaxants, antiepileptics, antipsychotics, antidepressants, opioids, selective serotonin reuptake inhibitors, and memantine was also associated with increased risk of falling.

Conclusions: Many medications were associated with falls in nursing homes residents in Japan. To prevent these falls, caregivers should provide adequate care, and healthcare professionals should consider switching or dose reduction for these medications.

Keywords: Accidental falls; Comorbidity; Nursing home; Prescription drugs; Risk factors.

MeSH terms

  • Accidental Falls / prevention & control*
  • Accidental Falls / statistics & numerical data
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Female
  • Humans
  • Japan
  • Logistic Models
  • Male
  • Nursing Homes*
  • Odds Ratio
  • Risk Factors