Conclusions We demonstrate a significant association between the use of PPIs and increased risk of fall .
In addition , there is potentially higher risk of fall among PPIs users over time
Background Fall prevention among older adults is a worldwide public health advocacy because of negative consequences of fall .
Recent studies have shown that proton pump inhibitors ( PPIs ) increase the risk of fall .
PPIs are among the widely prescribed medications oftentimes without clear indications .
Concerns for safety of long-term use of PPIs have been raised by numerous studies .
Long-term proton pump inhibitor therapy and falls and fractures in elderly women: a prospective cohort study.
Proton pump inhibitors ( PPIs ) are widely used in the elderly . Recent studies have suggested that long-term PPI therapy is associated with fractures in the elderly , however the mechanism remains unknown . We investigated the association between long-term PPI therapy ≥1 year and fracture risk factors including bone structure , falls , and balance-related function in a post hoc analysis of a longitudinal population -based prospect i ve cohort of elderly postmenopausal women and replicated the findings in a second prospect i ve study of falling in elderly postmenopausal women .  Long-term PPI therapy was associated with increased risk of falls and fracture-related hospitalizations ; adjusted odds ratio ( AOR ) 2.17 ; 95 % CI , 1.25 - 3.77 ; p = 0.006 and 1.95 ; 95 % CI , 1.20 - 3.16 ; p = 0.007 , respectively . In the replication study , long-term PPI use was associated with an increased risk of self-reported falling ; AOR , 1.51 ; 95 % CI , 1.00 - 2.27 ; p = 0.049 . No association of long-term PPI therapy with bone structure was observed ; however , question naire-assessed falls-associated metrics such as limiting outdoor activity ( p = 0.002 ) and indoor activity ( p = 0.001 ) due to fear of falling , dizziness ( p < 0.001 ) and numbness of feet ( p = 0.017 ) and objective clinical measurement such as Timed Up and Go ( p = 0.002 ) and Romberg eyes closed ( p = 0.025 ) tests were all significantly impaired in long-term PPI users . Long-term PPI users were also more likely to have low vitamin B12 levels than non-users ( 50 % versus 21 % , p = 0.003 ) . In conclusion , similar to previous studies , we identified an increased fracture risk in subjects on long-term PPI therapy . This increase in fracture risk in elderly women , already at high risk of fracture , appears to be mediated via increased falls risk and falling rather than impaired bone structure and should be carefully considered when prescribing long-term PPI therapy
Conclusions We demonstrate a significant association between the use of PPIs and increased risk of fall .
In addition , there is potentially higher risk of fall among PPIs users over time
Background Fall prevention among older adults is a worldwide public health advocacy because of negative consequences of fall .
Recent studies have shown that proton pump inhibitors ( PPIs ) increase the risk of fall .
PPIs are among the widely prescribed medications oftentimes without clear indications .
Concerns for safety of long-term use of PPIs have been raised by numerous studies .