Atypical antipsychotic medications and risk of falls in residents of aged care facilities.
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.
Hien
Le T T
le TT
School of Public Health, University of Sydney, Sydney, Australia.
Cumming
Robert G
RG
Cameron
Ian D
ID
Chen
Jian S
JS
Lord
Stephen R
SR
March
Lyn M
LM
Schwarz
Jennifer
J
Le Couteur
David G
DG
Sambrook
Philip N
PN
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*
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine