Certain medication doubles the risk of falls and fractures in elderly

Professor Libby Roughead and Doctor Kerrie Westaway, lead authors of the study from the University of South Australia, uncovered the impact of psychotropic drugs on the elderly and its contribution to falls.

One of the recent focusses of the Royal Commission into Aged Care Quality and Safety hearings was the overuse of psychotropic drugs on elderly people in residential aged care facilities, including on individuals who didn’t need the medication.

The researchers found that psychotropic drugs are used on a variety of conditions, like depression, pain and dementia, but the side effects can be quite significant, including drowsiness, dizziness and blurred vision, all of which increase the risk of falls and fractures.

Professor Roughead says, “Antidepressants, opioids, antiepileptic medicines, benzodiazepines (used to treat anxiety) and antipsychotics all increase the risk of hip fractures.

“Combining them increases the risk even further, up to five times in the case of starting antidepressants and anxiety medicines together.”

The study found there is one extra hip fracture for every 17 patients aged 80 years and over who will be treated for a year.

To reduce the risk of falling, the study suggested reducing psychotropic medication use, as well as increase exercise and other interventions like occupational therapy and podiatry.

Professor Roughead says, “We suggest to prescribers they consider whether patients really need some of their medicines anymore.

“For example, an SSRI (selective serotonin reuptake inhibitor) antidepressant may no longer be required if a patient is fully recovered from depression.

“Similarly, it may be possible to stop an antipsychotic in someone with dementia. Doctors should try stopping one medicine at a time, reducing it slowly over weeks or months.”

Australia is the highest user of antidepressants in the world, approximately 10 percent of adults take them each day.

An estimated 28,000 Australians over the age of 50 were hospitalised with a hip fracture in 2018.

Five percent of those Australians died in hospital and another 10 percent were discharged to an aged care facility.

The data for this research was pulled from the Australian Government Department of Veterans’ Affairs, comparing 8,828 veterans with hip fractures to 35,310 people of the same age and gender. It also examined their medicine use in the last six months.

The average age of the study was 88 years old and 63 percent were women.