Withdrawal of fall-risk-increasing drugs in older persons: effect on mobility test outcomes.
BACKGROUND
Previously, we have shown that withdrawal of fall-risk-increasing drugs (FRIDs) as a single intervention reduces falls incidence. Improvement of mobility may be an important factor in this finding and we therefore tested whether mobility tests improved after FRID withdrawal.


METHODS
In a prospective cohort study of 137 geriatric outpatients (age 77.7 +/- 5.7 years), FRIDs were withdrawn in all fallers, if possible, between April 2003 and November 2004. All patients underwent mobility testing at baseline, including a 10m walking test (WT), Timed 'Up & Go' Test (TUGT), Functional Reach Test (FRT), isometric quadriceps femoris muscle strength and a body sway test. Retesting occurred at a mean follow-up of 6.7 months. The effect of FRID withdrawal (discontinuation or dose reduction) on test outcomes was calculated using both multivariate linear and binary logistic regression analyses.


RESULTS
In the group of fallers with FRID withdrawal all mobility tests improved, as opposed to non-fallers and fallers without FRID withdrawal. After adjustment for confounders, the odds ratio of no improvement was 0.14 (95% CI 0.03, 0.59) for the TUGT, 0.19 (95% CI 0.04, 0.86) for the 10m WT, 0.48 (95% CI 0.14, 1.57) for the FRT, 0.46 (95% CI 0.14, 1.48) for the quadriceps strength test and 0.49 (95% CI 0.15, 1.62) for the body sway test.


CONCLUSIONS
The results of this study suggest that FRID withdrawal may be effective as a single intervention in a geriatric setting. In addition to reducing falls (as shown in our previous study), FRID withdrawal significantly improved 10m WT and TUGT results over a mean follow-up period of 6.7 months. These tests may therefore be useful tools for monitoring the clinical effect of FRID withdrawal.
van der Velde
Nathalie
N
Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
Stricker
Bruno H Ch
BH
Pols
Huibert A P
HA
van der Cammen
Tischa J M
TJ
D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001337:Autonomic Agents / Q000009:adverse effects; D002317:Cardiovascular Agents / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects; D008297:Male; D051346:Mobility Limitation; D011446:Prospective Studies; D011619:Psychotropic Drugs / Q000009:adverse effects*; D012307:Risk Factors; D013647:Task Performance and Analysis
D001337:Autonomic Agents; D002317:Cardiovascular Agents; D007004:Hypoglycemic Agents; D011619:Psychotropic Drugs
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