Falls are a leading cause of hospitalizations and serious injuries in adults 65 and older. Many studies have been able to identify risk factors and pose prevention solutions to modifiable risk for falls-such as side effects from some medication.
As the number of elderly adults grows (due to aging of the baby boomers), prescription drug use among the elderly population has also increased. According to a report published by the U.S. National Library of Medicine (NCBI), “The majority (72%) of people aged at least 55 years use at least one drug. In this age group, 20.3% are taking four or more drugs [Ziere et al. 2006].”
Drugs such as, non-steroidal anti-inflammatory drugs (NSAIDs like ibuprofen), opioids (such as morphine and hydrocodone), benzodiazepines (including lorazepam) and anticholinergic medications (such as Benadryl and Cogentin), as well as many anti-depressants (including Paxil, Zoloft, Prozac and Trazadone) are all linked to high risk for falls.
Many of these medications cannot be discontinued altogether, but here are some tips in reducing risks for individuals who must keep taking them:
•The risk factor for falls from taking benzodiazepines is the highest during the initial two weeks of taking the medication and also after long term use. Patients should use extreme caution during the initial drug therapy phase.
•Keep in mind that as the number of medications taken increases, so too does the risk for falls.
•When 3 or more drugs are prescribed as part of a regular medication regime, the risk for falls increased.
•Antidepressant medication poses an increased risk for falls, however, one type of antidepressant called “SSRIs” is thought to increase the risk of hip fracture by reducing bone mineral density.
•When opioids are prescribed in older adults, ask the physician about the possibility of starting with a low dose and slowly titrating up as needed to lower risks of falls.
•After a few days of taking opioids, most patients develop a tolerance to side effects and an increased alert status.
•Tricyclic antidepressants are thought to increase the risk of falls due to side effects such as, sedation, sleep disturbances, daytime sleepiness, orthostatic hypotension and confusion.
•Underlying medical conditions (such as osteoporosis) in patients on 3 or more medications or on specific types of medications, increases the risk of falls exponentially.
•Prescriptions for seniors requires close medical monitoring and assessment for falls risks.
Medical professionals and caregivers must seek out education on medications that pose a particular risk to falls, while implementing an effective falls prevention protocol, both at home and in medical facilities.
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