Conclusions The use of sedatives and hypnotics and antidepressants including tricyclic antidepressants , selective serotonin reuptake inhibitors , and serotonin norepinephrine reuptake inhibitors appears to be related with an increased risk of falls .
It is not clear if the use of antihypertensive medications is associated with the risk of falls in older people
Purpose Falls are an important public health problem in older people .
Medication use is considered a risk factor for falls .
This study systematic ally review ed recent studies to determine the medications that might be associated with the risk of falling in older people .
Angiotensin system-blocking medications are associated with fewer falls over 12 months in community-dwelling older people.
OBJECTIVES To investigate relationships between the use of cardiovascular medications , including angiotensin system-blocking medications ( ASBMs ) , orthostatic hypotension ( OH ) , fall risk , and falls in community-dwelling older people . DESIGN Prospect i ve cohort study . SETTING Sydney , Australia . PARTICIPANTS Five hundred twenty community-dwelling older adults . MEASUREMENTS Medical , medication and falls history were obtained from a st and ardized question naire in all participants . Blood pressure was measured in supine , seated , and tilted positions . Fall risk was assessed using the Physiological Profile Assessment ( PPA ) . Falls data were collected prospect ively for 12 months using monthly fall calendars . Participants were defined as nonfallers ( no falls ) and fallers ( ≥ 1 falls ) at the end of the 12-month follow-up . RESULTS Participants taking medications affecting the angiotensin system had greater quadriceps strength , but after adjusting for sex , this difference became insignificant . People taking ASBMs were less likely to fall ( odds ratio = 0.68 , 95 % confidence interval = 0.48 - 0.97 ) , and the association between ASBMs and falls remained significant after adjusting for sex , body mass index , PPA score , and psychotropic medication and 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitor ( statin ) use . OH was more frequently observed in participants taking alpha adrenergic receptor blockers ( α-blockers ) , but the presence of OH did not increase fall risk . CONCLUSION The use of cardiovascular medications in older people did not increase the risk of falls , and the use of ASBMs was associated with lower fall risk . The mechanisms for this apparent protective effect are unclear and appear not to be directly related to muscle strength . More research is required to eluci date the possible protective effects of certain cardiovascular medications in relation to falls in older people
Conclusions The use of sedatives and hypnotics and antidepressants including tricyclic antidepressants , selective serotonin reuptake inhibitors , and serotonin norepinephrine reuptake inhibitors appears to be related with an increased risk of falls .
It is not clear if the use of antihypertensive medications is associated with the risk of falls in older people
Purpose Falls are an important public health problem in older people .
Medication use is considered a risk factor for falls .
This study systematic ally review ed recent studies to determine the medications that might be associated with the risk of falling in older people .