ORs were generally higher for recurrent fallers than for all fallers .
This meta- analysis provides comprehensive evidence -based assessment of risk factors for falls in older people , confirming their multifactorial etiology .
Some nonspecific indicators of high baseline risk were also strong predictors of the risk of falling
BACKGROUND Falls are the main cause of accidental death in persons aged 65 years or older .
Effects of Central Nervous System Polypharmacy on Falls Liability in Community-Dwelling Elderly
Background : While central nervous system ( CNS ) active medications such as psychotropics and narcotic analgesics have been implicated in contributing to falls in older adults , the combined effect of multiple CNS-active medications has not been investigated . The purpose of this study was to examine the influence , in community-dwelling elderly , of ( 1 ) taking multiple CNS-active medications  on fall liability and ( 2 ) individual classes of CNS-active medications ( using discrete drug classification ) on the risk of falls after controlling for important confounders – age , mobility , cognition and depression . Methods : 305 community-dwelling male veterans ( age : 70–104 ) were screened at study entry for mobility , cognition and depression .  CNS-active medications were categorized as benzodiazepines , other sedative-hypnotics , neuroleptics , tricyclic antidepressants , and opioid analgesics . Subjects were prospect ively followed for 6 months to monitor falls ; at the end of this time period , subjects were classified as fallers ( at least one fall ) or nonfallers . The relationship between CNS-active drug use and falls was examined using multivariable analyses . Results : The risk of falls was significantly greater in  CNS-active medication users as compared with nonusers . Adjusted odds ratio for one CNS-active drug was 1.54 ( 95 % confidence interval 1.07–2.22 ) and for two or more agents 2.37 ( 95 % confidence interval 1.14–4.94 ) . Conclusions : In community-dwelling elderly , the use of multiple CNS-active medications is associated with enhanced falls liability , over and above the use of one CNS-active drug alone . This apparent dose-response relationship provides support for causality
ORs were generally higher for recurrent fallers than for all fallers .
This meta- analysis provides comprehensive evidence -based assessment of risk factors for falls in older people , confirming their multifactorial etiology .
Some nonspecific indicators of high baseline risk were also strong predictors of the risk of falling
BACKGROUND Falls are the main cause of accidental death in persons aged 65 years or older .