RED FLAG

Why on earth would a doctor prescribe a drug to a senior adult that increases the risk of falling?

If you are older, or there’s an older person you love, you need to know this.

A new report from the University of Buffalo School of Public Health states that in 2017, 94% of seniors (age 65+) were receiving drugs that increase fall risk. This is a massive increase from the 57% receiving such drugs in 1999. In the same period, deaths from falls doubled.

Even where falls aren’t directly lethal, head injuries and hip fractures can destroy quality of life.

Medications are among the most common causes of increased fall risk in older people.
Medications are usually among the easiest risk factors to change, when it comes to falls in older adults.
Medication-based risks are often missed by busy regular doctors. Older adults and family caregivers can make a big difference by being proactive in this area.”

Dr. Leslie Kernisan(5)

The drugs in question include products in the following categories:

  • Antidepressants,
  • Anti-anxiety drugs and benzodiazepines, such as diazepam (Valium) and lorazepam (Ativan) and Xanax
  • Anticonvulsants,
  • Antipsychotics,
  • Antihypertensives (for high blood pressure),
  • Opioids, codeine, hydrocodone (Vicodin), oxycodone (Percodan, Percocet), hydromorphone (Dilaudid), and fentanyl (Duragesic)
  • Sedative hypnotics,
  • As well as other nonprescription medications, such as those used to treat over-active bladder, such as oxybu-tynin (Ditropan) and tolterodine (Detrol)

Bluntly, as people get older, some of these medicines may cause more harm than good. The technical term for weaning people off of no-longer-useful medicine is “deprescribing.” Where risky medication can be eliminated, it should. Where it can not, everyone involved needs to be aware of the risk involved. You may have to force your doctor into this conversation if he doesn’t bring it up himself.

This brings us back to a fundamental point: each person needs someone who will aggressively advocate for them when they cannot do this themselves. That should involve a living will and a formal medical power of attorney. It doesn’t matter how young or old you are — your crystal ball is no better than anyone else’s.

Sources:

  1. Amy L. Shaver, Collin M. Clark, Mary Hejna, Steven Feuerstein, Robert G. Wahler, David M. Jacobs. Trends in fall‐related mortality and fall risk increasing drugs among older individuals in the United States,1999–2017. Pharmacoepidemiology and Drug Safety, 2021; DOI: 10.1002/pds.5201
  2. University at Buffalo. “94% of older adults prescribed drugs that raise risk of falling: From 1999-2017, more than 7.8 billion fall-risk-increasing drugs were prescribed to older adults in the US, and deaths from falls doubled.” ScienceDaily. ScienceDaily, 16 March 2021. www.sciencedaily.com/releases/2021/03/210316100647.htm
  3. https://www.health.harvard.edu/staying-healthy/medications-that-increase-your-risk-of-falling
  4. https://pubmed.ncbi.nlm.nih.gov/29396189/
  5. https://betterhealthwhileaging.net/preventing-falls-10-types-of-medications-to-review/
    Dr. Kernisan is one of my favorite writers on senior care.

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