By Sherry M. Hankins, Pharm D, BCGP
Did you know that almost one-third of people over the age of 65 fall each year, leading to 7million injuries and over 27,000 deaths? The risk of falling is one of the most important factors to consider when doctors prescribe medications for elderly patients. Many medications can increase fall risk due to an increased incidence for side effects, drug interactions, and reduced metabolism and clearance of drugs from the body as we get older.
The good news is that a patient’s medications are usually among the easiest risk factors to change when it comes to preventing falls.
There are 3 categories of medication that should be reviewed to prevent falls:
Medications that affect the brain.
This is a very broad category that includes medications to treat insomnia, anxiety, and pain which are unfortunately common issues that need treatment in the elderly. This category also includes medications used to control difficult behaviors associated with Alzheimer’s disease and other dementias. Also included are over the counter medications for motion sickness, vertigo, seasonal allergies and itching.
Medications that affect blood pressure.
Older adults often experience a drop in blood pressure when they stand up. This is called postural hypotension. Most medications used to treat high blood pressure can cause or worsen this condition. Also included in this category are medications to treat an enlarged prostate gland and related medications to improve urination.
Medications that affect blood sugar.
Many diabetes medications can cause or worsen hypoglycemia. Studies have shown that hypoglycemia is associated with falls in older adults.
A medication review by a doctor or pharmacist can help pinpoint these meds that increase fall risk. Recommendations can be made to lower the doses, discontinue these meds or replace them with safer options if appropriate.
Sherry M.Hankins, Pharm D, BCGP, has attained her board certification in geriatric pharmacy, and is one of a small number of board-certified geriatric pharmacists in the state of Tennessee. Sherry is one of two doctors of pharmacy responsible for participant care in the Program of All-inclusive Care for the Elderly (PACE) in Chattanooga, TN. PACE is an alternative to nursing home care that uses adult day services and home care to help people live in their own homes.