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Polypharmacy as a risk for fall occurrence in geriatric outpatients

Authors


Dr Masahiro Akishita MD PhD, Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Email: akishita-tky@umin.ac.jp

Abstract

Objective:  To investigate the predictors of falls, such as comorbidity and medication, in geriatric outpatients in a longitudinal observational study.

Methods:  A total of 172 outpatients (45 men and 126 women, mean age 76.9 ± 7.0 years) were evaluated. Physical examination, clinical history and medication profile were obtained from each patient at baseline. These patients were followed for up to 2 years and falls were self-reported to their physicians. The factors associated with falls were analyzed statistically.

Results:  A total of 32 patients experienced falls within 2 years. On univariate analysis, older age, osteoporosis, number of comorbid conditions and number of drugs were significantly associated with falls within 2 years. On multiple logistic regression analysis, the number of drugs was associated with falls, independent of age, sex, number of comorbid conditions and other factors that were significantly associated in univariate analysis. A receiver–operator curve evaluating the optimal cut-off value for the number of drugs showed that taking five or more drugs was a significant risk.

Conclusion:  In geriatric outpatients, polypharmacy is associated with falls. Intervention studies are needed to clarify the causal relationship between polypharmacy, comorbidity and falls. Geriatr Gerontol Int 2012; 12: 425–430.

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