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Senior Care Pharmacist Consulting in St. Louis

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Fall Risk & Medications

As we age, the risk of falling increases.  More than one-third of adults aged 65 and older fall each year.  Falls are the leading cause of unintentional injuries in the home for older adults and up to 95% of hip fractures result from a fall.  Thus, preventing falls has become a national health goal. 

Medications are one of the many factors that can increase the risk of falls.  Some of the other factors include certain medical conditions, poor nutrition, and smoking.  In addition, natural changes of aging such as decreased vision, balance, and muscle or joint strength can contribute to the risk of falling.  The good news is that falls can be prevented. 

Basic preventive measures include regular physical activity, adequate nutritional intake, quitting smoking, and limiting alcohol intake.  Every older adult should speak with his or her doctor about fall risk and specific ways to reduce that risk.  A regular medication review is a key preventive measure that every patient should undertake. Some of the more common drugs or drug classes that are reported to increase fall risk include:

  • Anticonvulsants
  • Antipsychotic medicines or mood stabilizers
  • Digoxin
  • Diuretics
  • Opioid pain medicines
  • Sedatives
  • Tricyclic and “SSRI” antidepressants
  • Others

In general, fall-risk medicines are known to contribute in various ways to symptoms of dizziness, drowsiness, decreased alertness, confusion, blurred vision, and unsteady gait or imbalance.  These problematic effects can occur even at “usual” dosages – especially in older adults.  A complete medication screening for fall risk must also address drug interactions and use of nonprescription medicines and dietary supplements.  

Now is a good time for all older adults to request a review of their medicines (prescription and nonprescription) to identify possible fall risk concerns.  Sometimes a dose can be lowered or a drug stopped if no longer needed or alternative, non-drug approaches can be tried to manage a condition.  Pharmacists are the most qualified health care professionals to review medications.  They can help you work closely with your doctor to address medications and fall risk.   

Revised Oct. 10, 2014; Author:  Hedva Barenholtz Levy PharmD, BCPS, CGP 

Resources:

Home Safety Council. Safe Steps, Falls prevention for seniors.  2004.  

Roberto KA et al. Osteoporosis. In Healthy Aging, Principles and Clinical Practice for Clinicians. Wolters-Kluwer 2014: Philadelphia. 

 

The information provided on this website is for general educational purposes only.  It is not intended to be used as a substitute for medical advice.