Atypical Antipsychotic Medications and Risk of Falls in Residents of Aged Care Facilities
Version of Record online: 7 JUN 2005
Journal of the American Geriatrics Society
Volume 53, Issue 8, pages 1290–1295, August 2005
How to Cite
Hien, L. T. T., Cumming, R. G., Cameron, I. D., Chen, J. S., Lord, S. R., March, L. M., Schwarz, J., Le Couteur, D. G. and Sambrook, P. N. (2005), Atypical Antipsychotic Medications and Risk of Falls in Residents of Aged Care Facilities. Journal of the American Geriatrics Society, 53: 1290–1295. doi: 10.1111/j.1532-5415.2005.53403.x
- Issue online: 25 JUL 2005
- Version of Record online: 7 JUN 2005
- accidental falls;
- aged care;
- psychotropic medications;
Objectives: To determine whether use of atypical antipsychotics (olanzapine and risperidone) is associated with lower risk of falls than use of typical antipsychotics.
Design: Prospective cohort study with 1-month follow-up.
Setting: Residential aged care facilities in Sydney, Australia.
Participants: Two thousand five people aged 65 to 104 (mean age 86).
Measurements: Medication use at baseline was collected from medical records. Data on potential confounders were collected at interview and physical examination and from medical records. The outcome was accidental falls (one or more).
Results: One thousand one hundred seven subjects (55%) used at least one type of psychotropic medication, with 289 (14%) using an antipsychotic. There were 82 olanzapine users, 38 risperidone users, and 181 users of typical antipsychotics. Eleven percent of subjects (n=226) had at least one fall during follow-up. After adjusting for a comprehensive range of falls risk factors, hazard ratios (HRs) for falls were 1.35 (95% confidence interval (CI)=0.87–2.09) for typical antipsychotics, 1.32 (95% CI=0.57–3.06) for risperidone, and 1.74 (95% CI=1.04–2.90) for olanzapine. Antidepressants were also associated with falls (adjusted HR=1.45, 95% CI=1.09–1.93).
Conclusion: Despite fewer extrapyramidal side effects, atypical antipsychotic medications are not associated with fewer falls than the older, more-established antipsychotics.