Smart medication management key to fall prevention

FallFalls among the elderly are nothing to take lightly.

The Centers for Disease Control and Prevention (CDC) cite falls as the leading cause of both fatal and nonfatal injuries among Americans 65 and older. In 2012, 2.4 million nonfatal falls among this age group were treated in emergency departments, and more than 722,000 of these patients were hospitalized. In 2011, about 22,900 members of this demographic died from unintentional fall injuries.

Multiple government and nonprofit agencies, such as the CDC and National Council on Aging, say effective medication management is an important way to prevent falls and associated injuries. Many people aged 65 and older take multiple medications, thus raising the specter of drug interactions and adverse side effects, such as dizziness, that could lead to falls.

A 2013 case study in the journal Canadian Family Physician told of an 83-year-old woman taking 17 medications who had a history of falling about once per month. A review of her drug regimen and medical history allowed her doctor to slowly titrate her off two of her three cardiac medications.

Adjustments to her pain medications were also made, all of which resulted in a substantial increase in balance, mobility and a reduction in dizziness. Additionally, the patient had no further falls after 10 weeks.

“By assessing each medication for indication, effectiveness, safety, and compliance, we were able to gradually taper and discontinue cardiovascular medications in order to improve balance and reduce fall risk,” the case study authors write.

In a collection of research complied for the National Council on Aging’s 2005 Falls Free National Action Plan, Kathleen Cameron, R.Ph, MPH, lists a bevy of medications classes that can increase fall risk. These include antidepressants, benzodiazepines and cardiac medications, just to name a few.

Cameron writes that changes in cognitive or physical function such as dizziness, lightheadedness or confusion in seniors provide red flags that may signal the need for a complete assessment by a medical professional.

“Medication use may cause these changes and require interventions aimed at medication modification, such as a dosage reduction, drug replacement or drug elimination, to reduce the risk of falls,” Cameron says.

For more information on fall prevention, visit the National Council on Aging’s website or consult the information available on the CDC website.

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