TY - JOUR
T1 - Central Nervous System Medication Changes and Falls in Nursing Home Residents
AU - Sorock, Gary S.
AU - Quigley, Patricia A.
AU - Rutledge, Michelle K.
AU - Taylor, Jennifer
AU - Luo, Xianghua
AU - Foulis, Philip
AU - Wang, Mei Cheng
AU - Varadhan, Ravi
AU - Bellantoni, Michele
AU - Baker, Susan P.
PY - 2009/9
Y1 - 2009/9
N2 - We investigated the role of changes in 6 mutually exclusive medication categories on the risk of falling in nursing home residents. The 6 categories were: gastrointestinal, hypoglycemics, antibiotics, central nervous system (CNS) acting, cardiovascular disease agents, and analgesics. A change was defined as a new start, a dose change, an as-needed dose, or a discontinuation. Incident reports were used to determine the fall date and time. Medication records were abstracted to identify the date of changes before the date of each fall. The 158 residents who fell had 419 recorded falls during 2002 and 2003; they were on average 80.5 years old (SD 8.1; range 65-103), and 67% were men. Within 1-3 days of a change in any CNS medication (antipsychotic, sedative, antidepressant, or antiseizure), the fall risk (odds ratio) increased 3.4-fold (95% confidence interval 1.2-9.5) using 7-9 days prior as comparable control days. No changes in other medication categories had a significant effect on fall risk. These data suggest that the risk of falls among nursing home residents is significantly elevated within 3 days of a CNS medication change.
AB - We investigated the role of changes in 6 mutually exclusive medication categories on the risk of falling in nursing home residents. The 6 categories were: gastrointestinal, hypoglycemics, antibiotics, central nervous system (CNS) acting, cardiovascular disease agents, and analgesics. A change was defined as a new start, a dose change, an as-needed dose, or a discontinuation. Incident reports were used to determine the fall date and time. Medication records were abstracted to identify the date of changes before the date of each fall. The 158 residents who fell had 419 recorded falls during 2002 and 2003; they were on average 80.5 years old (SD 8.1; range 65-103), and 67% were men. Within 1-3 days of a change in any CNS medication (antipsychotic, sedative, antidepressant, or antiseizure), the fall risk (odds ratio) increased 3.4-fold (95% confidence interval 1.2-9.5) using 7-9 days prior as comparable control days. No changes in other medication categories had a significant effect on fall risk. These data suggest that the risk of falls among nursing home residents is significantly elevated within 3 days of a CNS medication change.
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U2 - 10.1016/j.gerinurse.2009.07.001
DO - 10.1016/j.gerinurse.2009.07.001
M3 - Article
C2 - 19818269
AN - SCOPUS:70349767055
VL - 30
SP - 334
EP - 340
JO - Geriatric Nursing
JF - Geriatric Nursing
SN - 0197-4572
IS - 5
ER -