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J Am Geriatr Soc. 2015 Aug;63(8):1561-9. doi: 10.1111/jgs.13543. Epub 2015 Jul 22.

Use of Medications with Anticholinergic Activity and Self-Reported Injurious Falls in Older Community-Dwelling Adults.

Author information

1
Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland.
2
School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.
3
Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St. James' Hospital, Dublin, Ireland.
4
School of Life and Health Sciences, University of Aston, Birmingham, UK.
5
Aston Research Centre for Healthy Ageing, University of Aston, Birmingham, UK.
6
Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.
7
Princess Royal University Hospital, King's College National Health Service Foundation Trust, London, UK.
8
Department of Digital Arts and Electronics, University of Kent, Canterbury, UK.
9
Trinity College Institute of Neuroscience, St. James' Hospital, Dublin, Ireland.

Abstract

OBJECTIVES:

To assess the association between the use of medications with anticholinergic activity and the subsequent risk of injurious falls in older adults.

DESIGN:

Prospective, population-based study using data from The Irish Longitudinal Study on Ageing.

SETTING:

Irish population.

PARTICIPANTS:

Community-dwelling men and women without dementia aged 65 and older (N = 2,696).

MEASUREMENTS:

Self-reported injurious falls reported once approximately 2 years after baseline interview. Self-reported regular medication use at baseline interview. Pharmacy dispensing records from the Irish Health Service Executive Primary Care Reimbursement Service in a subset (n = 1,553).

RESULTS:

Nine percent of men and 17% of women reported injurious falls. In men, the use of medications with definite anticholinergic activity was associated with greater risk of subsequent injurious falls (adjusted relative risk (aRR) = 2.55, 95% confidence interval (CI) = 1.33-4.88), but the risk of having any fall and the number of falls reported were not significantly greater. Greater anticholinergic burden was associated with greater injurious falls risk. No associations were observed for women. Findings were similar using pharmacy dispensing records. The aRR for medications with definite anticholinergic activity dispensed in the month before baseline and subsequent injurious falls in men was 2.53 (95% CI = 1.15-5.54).

CONCLUSION:

The regular use of medications with anticholinergic activity is associated with subsequent injurious falls in older men, although falls were self-reported after a 2-year recall and so may have been underreported. Further research is required to validate this finding in men and to consider the effect of duration and dose of anticholinergic medications.

KEYWORDS:

anticholinergic; antimuscarinic; elderly; falls; injury

PMID:
26200894
DOI:
10.1111/jgs.13543
[Indexed for MEDLINE]
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