TY - JOUR
T1 - Antidepressant Use and Recurrent Falls in Community-Dwelling Older Adults
T2 - Findings From the Health ABC Study
AU - Marcum, Zachary A.
AU - Perera, Subashan
AU - Thorpe, Joshua M.
AU - Switzer, Galen E.
AU - Castle, Nicholas G.
AU - Strotmeyer, Elsa S.
AU - Simonsick, Eleanor M.
AU - Ayonayon, Hilsa N.
AU - Phillips, Caroline L.
AU - Rubin, Susan
AU - Zucker-Levin, Audrey R.
AU - Bauer, Douglas C.
AU - Shorr, Ronald I.
AU - Kang, Yihuang
AU - Gray, Shelly L.
AU - Hanlon, Joseph T.
N1 - Publisher Copyright:
© 2016, © The Author(s) 2016.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Background: Few studies have compared the risk of recurrent falls across various antidepressant agents—using detailed dosage and duration data—among community-dwelling older adults, including those who have a history of a fall/fracture. Objective: To examine the association of antidepressant use with recurrent falls, including among those with a history of falls/fractures, in community-dwelling elders. Methods: This was a longitudinal analysis of 2948 participants with data collected via interview at year 1 from the Health, Aging and Body Composition study and followed through year 7 (1997-2004). Any antidepressant medication use was self-reported at years 1, 2, 3, 5, and 6 and further categorized as (1) selective serotonin reuptake inhibitors (SSRIs), (2) tricyclic antidepressants, and (3) others. Dosage and duration were examined. The outcome was recurrent falls (≥2) in the ensuing 12-month period following each medication data collection. Results: Using multivariable generalized estimating equations models, we observed a 48% greater likelihood of recurrent falls in antidepressant users compared with nonusers (adjusted odds ratio [AOR] = 1.48; 95% CI = 1.12-1.96). Increased likelihood was also found among those taking SSRIs (AOR = 1.62; 95% CI = 1.15-2.28), with short duration of use (AOR = 1.47; 95% CI = 1.04-2.00), and taking moderate dosages (AOR = 1.59; 95% CI = 1.15-2.18), all compared with no antidepressant use. Stratified analysis revealed an increased likelihood among users with a baseline history of falls/fractures compared with nonusers (AOR = 1.83; 95% CI = 1.28-2.63). Conclusion: Antidepressant use overall, SSRI use, short duration of use, and moderate dosage were associated with recurrent falls. Those with a history of falls/fractures also had an increased likelihood of recurrent falls.
AB - Background: Few studies have compared the risk of recurrent falls across various antidepressant agents—using detailed dosage and duration data—among community-dwelling older adults, including those who have a history of a fall/fracture. Objective: To examine the association of antidepressant use with recurrent falls, including among those with a history of falls/fractures, in community-dwelling elders. Methods: This was a longitudinal analysis of 2948 participants with data collected via interview at year 1 from the Health, Aging and Body Composition study and followed through year 7 (1997-2004). Any antidepressant medication use was self-reported at years 1, 2, 3, 5, and 6 and further categorized as (1) selective serotonin reuptake inhibitors (SSRIs), (2) tricyclic antidepressants, and (3) others. Dosage and duration were examined. The outcome was recurrent falls (≥2) in the ensuing 12-month period following each medication data collection. Results: Using multivariable generalized estimating equations models, we observed a 48% greater likelihood of recurrent falls in antidepressant users compared with nonusers (adjusted odds ratio [AOR] = 1.48; 95% CI = 1.12-1.96). Increased likelihood was also found among those taking SSRIs (AOR = 1.62; 95% CI = 1.15-2.28), with short duration of use (AOR = 1.47; 95% CI = 1.04-2.00), and taking moderate dosages (AOR = 1.59; 95% CI = 1.15-2.18), all compared with no antidepressant use. Stratified analysis revealed an increased likelihood among users with a baseline history of falls/fractures compared with nonusers (AOR = 1.83; 95% CI = 1.28-2.63). Conclusion: Antidepressant use overall, SSRI use, short duration of use, and moderate dosage were associated with recurrent falls. Those with a history of falls/fractures also had an increased likelihood of recurrent falls.
KW - aging
KW - antidepressants
KW - drug-related problems
KW - epidemiology
KW - geriatrics
KW - outcomes research/analysis
KW - pharmacoepidemiology
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U2 - 10.1177/1060028016644466
DO - 10.1177/1060028016644466
M3 - Article
C2 - 27066988
AN - SCOPUS:84979008583
SN - 1060-0280
VL - 50
SP - 525
EP - 533
JO - Annals of Pharmacotherapy
JF - Annals of Pharmacotherapy
IS - 7
ER -