title: Atypical antipsychotic medications and risk of falls in residents of aged care facilities.
abstract: OBJECTIVE
  To determine whether use of atypical antipsychotics (olanzapine and risperidone) is associated with lower risk of falls than use of typical antipsychotics.
  
  
  METHODS
  Prospective cohort study with 1-month follow-up.
  
  
  METHODS
  Residential aged care facilities in Sydney, Australia.
  
  
  METHODS
  Two thousand five people aged 65 to 104 (mean age 86).
  
  
  METHODS
  Medication use at baseline was collected from medical records. Data on potential confounders were collected at interview and physical examination and from medical records. The outcome was accidental falls (one or more).
  
  
  RESULTS
  One thousand one hundred seven subjects (55%) used at least one type of psychotropic medication, with 289 (14%) using an antipsychotic. There were 82 olanzapine users, 38 risperidone users, and 181 users of typical antipsychotics. Eleven percent of subjects (n=226) had at least one fall during follow-up. After adjusting for a comprehensive range of falls risk factors, hazard ratios (HRs) for falls were 1.35 (95% confidence interval (CI)=0.87-2.09) for typical antipsychotics, 1.32 (95% CI=0.57-3.06) for risperidone, and 1.74 (95% CI=1.04-2.90) for olanzapine. Antidepressants were also associated with falls (adjusted HR=1.45, 95% CI=1.09-1.93).
  
  
  CONCLUSIONS
  Despite fewer extrapyramidal side effects, atypical antipsychotic medications are not associated with fewer falls than the older, more-established antipsychotics.
authors.affiliation: School of Public Health, University of Sydney, Sydney, Australia.
authors.forename: Le T T
authors.initials: le TT
authors.lastname: Hien
authors.forename: Robert G
authors.initials: RG
authors.lastname: Cumming
authors.forename: Ian D
authors.initials: ID
authors.lastname: Cameron
authors.forename: Jian S
authors.initials: JS
authors.lastname: Chen
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
authors.forename: Lyn M
authors.initials: LM
authors.lastname: March
authors.forename: Jennifer
authors.initials: J
authors.lastname: Schwarz
authors.forename: David G
authors.initials: DG
authors.lastname: Le Couteur
authors.forename: Philip N
authors.initials: PN
authors.lastname: Sambrook
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009735:Nursing Homes; D000077152:Olanzapine; D011446:Prospective Studies; D018967:Risperidone / Q000627:therapeutic use*
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine