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Ann Pharmacother. 2016 Jul;50(7):525-33. doi: 10.1177/1060028016644466. Epub 2016 Apr 11.

Antidepressant Use and Recurrent Falls in Community-Dwelling Older Adults: Findings From the Health ABC Study.

Author information

1
University of Washington, Seattle, WA, USA zmarcum@uw.edu.
2
University of Pittsburgh, Pittsburgh, PA, USA.
3
University of Pittsburgh, Pittsburgh, PA, USA VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
4
National Institute on Aging, Baltimore, MD, USA.
5
University of California-San Francisco, CA, USA.
6
University of Tennessee Health Sciences Center, Memphis, TN, USA.
7
Veterans Affairs Medical Center, Gainesville, FL, USA.
8
University of Washington, Seattle, WA, USA.

Abstract

BACKGROUND:

Few studies have compared the risk of recurrent falls across various antidepressant agents-using detailed dosage and duration data-among community-dwelling older adults, including those who have a history of a fall/fracture.

OBJECTIVE:

To examine the association of antidepressant use with recurrent falls, including among those with a history of falls/fractures, in community-dwelling elders.

METHODS:

This was a longitudinal analysis of 2948 participants with data collected via interview at year 1 from the Health, Aging and Body Composition study and followed through year 7 (1997-2004). Any antidepressant medication use was self-reported at years 1, 2, 3, 5, and 6 and further categorized as (1) selective serotonin reuptake inhibitors (SSRIs), (2) tricyclic antidepressants, and (3) others. Dosage and duration were examined. The outcome was recurrent falls (≥2) in the ensuing 12-month period following each medication data collection.

RESULTS:

Using multivariable generalized estimating equations models, we observed a 48% greater likelihood of recurrent falls in antidepressant users compared with nonusers (adjusted odds ratio [AOR] = 1.48; 95% CI = 1.12-1.96). Increased likelihood was also found among those taking SSRIs (AOR = 1.62; 95% CI = 1.15-2.28), with short duration of use (AOR = 1.47; 95% CI = 1.04-2.00), and taking moderate dosages (AOR = 1.59; 95% CI = 1.15-2.18), all compared with no antidepressant use. Stratified analysis revealed an increased likelihood among users with a baseline history of falls/fractures compared with nonusers (AOR = 1.83; 95% CI = 1.28-2.63).

CONCLUSION:

Antidepressant use overall, SSRI use, short duration of use, and moderate dosage were associated with recurrent falls. Those with a history of falls/fractures also had an increased likelihood of recurrent falls.

KEYWORDS:

aging; antidepressants; drug-related problems; epidemiology; geriatrics; outcomes research/analysis; pharmacoepidemiology

PMID:
27066988
PMCID:
PMC4892949
DOI:
10.1177/1060028016644466
[Indexed for MEDLINE]
Free PMC Article

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