Polypharmacy as a risk for fall occurrence in geriatric outpatients.
OBJECTIVE
To investigate the predictors of falls, such as comorbidity and medication, in geriatric outpatients in a longitudinal observational study.


METHODS
A total of 172 outpatients (45 men and 126 women, mean age 76.9 ± 7.0 years) were evaluated. Physical examination, clinical history and medication profile were obtained from each patient at baseline. These patients were followed for up to 2 years and falls were self-reported to their physicians. The factors associated with falls were analyzed statistically.


RESULTS
A total of 32 patients experienced falls within 2 years. On univariate analysis, older age, osteoporosis, number of comorbid conditions and number of drugs were significantly associated with falls within 2 years. On multiple logistic regression analysis, the number of drugs was associated with falls, independent of age, sex, number of comorbid conditions and other factors that were significantly associated in univariate analysis. A receiver-operator curve evaluating the optimal cut-off value for the number of drugs showed that taking five or more drugs was a significant risk.


CONCLUSIONS
In geriatric outpatients, polypharmacy is associated with falls. Intervention studies are needed to clarify the causal relationship between polypharmacy, comorbidity and falls.
Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Taro
T
Kojima
Masahiro
M
Akishita
Tetsuro
T
Nakamura
Kazushi
K
Nomura
Sumito
S
Ogawa
Katsuya
K
Iijima
Masato
M
Eto
Yasuyoshi
Y
Ouchi
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D010045:Outpatients; D019338:Polypharmacy; D012307:Risk Factors