Number and dosage of central nervous system medications on recurrent falls in community elders

The health, aging and body composition study

Joseph T. Hanlon, Robert M. Boudreau, Yazan F. Roumani, Anne B. Newman, Christine M. Ruby, Rollin M. Wright, Sarah N. Hilmer, Ronald I. Shorr, Douglas C. Bauer, Eleanor Marie Simonsick, Stephanie A. Studenski

Research output: Contribution to journalArticle

Abstract

Background. Few studies have examined the risk of multiple or high doses of combined central nervous system (CNS) medication use for recurrent falls in the elderly. The study objective was to evaluate whether multiple- or high-dose CNS medication use in older adults was associated with a higher risk of recurrent (≥2) falls. Methods. This longitudinal cohort study included 3,055 participants from the Health, Aging and Body Composition study who were well functioning at baseline. CNS medication use (benzodiazepine and opioid receptor agonists, antipsychotics, antidepressants) was determined annually (except Year 4) during in-person interviews. The number and summated standard daily doses (SDDs; low, medium, and high) of CNS medications were computed. Falls 1 year later were ascertained annually for 5 years. Results. For a period of 5 years, as many as 24.1% of CNS medication users took 2+ agents annually, whereas as no more than 18.9% of CNS medication users took high doses annually (3+ SDDs). Yearly, as many as 9.7% of participants reported recurrent falls. Multivariable Generalized Estimating Equation analyses showed that multiple CNS medication users compared with never users had an increased risk of sustaining 2+ falls (adjusted odds ratio [OR] 1.95; 95% confidence interval [CI] 1.35-2.81). Those taking high (3+) CNS SDDs also exhibited an increased risk of 2+ falls (adjusted OR 2.89; 95% CI 1.96-4.25). Conclusions. Higher total daily doses of CNS medications were associated with recurrent falls. Further studies are needed to determine the impact of reducing the number of CNS medications and/or dosage on recurrent falls.

Original languageEnglish (US)
Pages (from-to)492-498
Number of pages7
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume64
Issue number4
DOIs
StatePublished - Apr 2009
Externally publishedYes

Fingerprint

Body Composition
Central Nervous System
Health
Odds Ratio
Confidence Intervals
Opioid Receptors
GABA-A Receptors
Antidepressive Agents
Antipsychotic Agents
Longitudinal Studies
Cohort Studies
Interviews

Keywords

  • Aged
  • Central nervous system medications
  • Falls

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology
  • Medicine(all)

Cite this

Number and dosage of central nervous system medications on recurrent falls in community elders : The health, aging and body composition study. / Hanlon, Joseph T.; Boudreau, Robert M.; Roumani, Yazan F.; Newman, Anne B.; Ruby, Christine M.; Wright, Rollin M.; Hilmer, Sarah N.; Shorr, Ronald I.; Bauer, Douglas C.; Simonsick, Eleanor Marie; Studenski, Stephanie A.

In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences, Vol. 64, No. 4, 04.2009, p. 492-498.

Research output: Contribution to journalArticle

Hanlon, Joseph T. ; Boudreau, Robert M. ; Roumani, Yazan F. ; Newman, Anne B. ; Ruby, Christine M. ; Wright, Rollin M. ; Hilmer, Sarah N. ; Shorr, Ronald I. ; Bauer, Douglas C. ; Simonsick, Eleanor Marie ; Studenski, Stephanie A. / Number and dosage of central nervous system medications on recurrent falls in community elders : The health, aging and body composition study. In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences. 2009 ; Vol. 64, No. 4. pp. 492-498.
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abstract = "Background. Few studies have examined the risk of multiple or high doses of combined central nervous system (CNS) medication use for recurrent falls in the elderly. The study objective was to evaluate whether multiple- or high-dose CNS medication use in older adults was associated with a higher risk of recurrent (≥2) falls. Methods. This longitudinal cohort study included 3,055 participants from the Health, Aging and Body Composition study who were well functioning at baseline. CNS medication use (benzodiazepine and opioid receptor agonists, antipsychotics, antidepressants) was determined annually (except Year 4) during in-person interviews. The number and summated standard daily doses (SDDs; low, medium, and high) of CNS medications were computed. Falls 1 year later were ascertained annually for 5 years. Results. For a period of 5 years, as many as 24.1{\%} of CNS medication users took 2+ agents annually, whereas as no more than 18.9{\%} of CNS medication users took high doses annually (3+ SDDs). Yearly, as many as 9.7{\%} of participants reported recurrent falls. Multivariable Generalized Estimating Equation analyses showed that multiple CNS medication users compared with never users had an increased risk of sustaining 2+ falls (adjusted odds ratio [OR] 1.95; 95{\%} confidence interval [CI] 1.35-2.81). Those taking high (3+) CNS SDDs also exhibited an increased risk of 2+ falls (adjusted OR 2.89; 95{\%} CI 1.96-4.25). Conclusions. Higher total daily doses of CNS medications were associated with recurrent falls. Further studies are needed to determine the impact of reducing the number of CNS medications and/or dosage on recurrent falls.",
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T2 - The health, aging and body composition study

AU - Hanlon, Joseph T.

AU - Boudreau, Robert M.

AU - Roumani, Yazan F.

AU - Newman, Anne B.

AU - Ruby, Christine M.

AU - Wright, Rollin M.

AU - Hilmer, Sarah N.

AU - Shorr, Ronald I.

AU - Bauer, Douglas C.

AU - Simonsick, Eleanor Marie

AU - Studenski, Stephanie A.

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Y1 - 2009/4

N2 - Background. Few studies have examined the risk of multiple or high doses of combined central nervous system (CNS) medication use for recurrent falls in the elderly. The study objective was to evaluate whether multiple- or high-dose CNS medication use in older adults was associated with a higher risk of recurrent (≥2) falls. Methods. This longitudinal cohort study included 3,055 participants from the Health, Aging and Body Composition study who were well functioning at baseline. CNS medication use (benzodiazepine and opioid receptor agonists, antipsychotics, antidepressants) was determined annually (except Year 4) during in-person interviews. The number and summated standard daily doses (SDDs; low, medium, and high) of CNS medications were computed. Falls 1 year later were ascertained annually for 5 years. Results. For a period of 5 years, as many as 24.1% of CNS medication users took 2+ agents annually, whereas as no more than 18.9% of CNS medication users took high doses annually (3+ SDDs). Yearly, as many as 9.7% of participants reported recurrent falls. Multivariable Generalized Estimating Equation analyses showed that multiple CNS medication users compared with never users had an increased risk of sustaining 2+ falls (adjusted odds ratio [OR] 1.95; 95% confidence interval [CI] 1.35-2.81). Those taking high (3+) CNS SDDs also exhibited an increased risk of 2+ falls (adjusted OR 2.89; 95% CI 1.96-4.25). Conclusions. Higher total daily doses of CNS medications were associated with recurrent falls. Further studies are needed to determine the impact of reducing the number of CNS medications and/or dosage on recurrent falls.

AB - Background. Few studies have examined the risk of multiple or high doses of combined central nervous system (CNS) medication use for recurrent falls in the elderly. The study objective was to evaluate whether multiple- or high-dose CNS medication use in older adults was associated with a higher risk of recurrent (≥2) falls. Methods. This longitudinal cohort study included 3,055 participants from the Health, Aging and Body Composition study who were well functioning at baseline. CNS medication use (benzodiazepine and opioid receptor agonists, antipsychotics, antidepressants) was determined annually (except Year 4) during in-person interviews. The number and summated standard daily doses (SDDs; low, medium, and high) of CNS medications were computed. Falls 1 year later were ascertained annually for 5 years. Results. For a period of 5 years, as many as 24.1% of CNS medication users took 2+ agents annually, whereas as no more than 18.9% of CNS medication users took high doses annually (3+ SDDs). Yearly, as many as 9.7% of participants reported recurrent falls. Multivariable Generalized Estimating Equation analyses showed that multiple CNS medication users compared with never users had an increased risk of sustaining 2+ falls (adjusted odds ratio [OR] 1.95; 95% confidence interval [CI] 1.35-2.81). Those taking high (3+) CNS SDDs also exhibited an increased risk of 2+ falls (adjusted OR 2.89; 95% CI 1.96-4.25). Conclusions. Higher total daily doses of CNS medications were associated with recurrent falls. Further studies are needed to determine the impact of reducing the number of CNS medications and/or dosage on recurrent falls.

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