title: Polypharmacy including falls risk-increasing medications and subsequent falls in community-dwelling middle-aged and older adults.
abstract: BACKGROUND
  polypharmacy is an important risk factor for falls, but recent studies suggest only when including medications associated with increasing the risk of falls.
  
  
  METHODS
  a prospective, population-based cohort study.
  
  
  METHODS
  6,666 adults aged ≥50 years from The Irish Longitudinal study on Ageing.
  
  
  METHODS
  participants reported regular medication use at baseline. Any subsequent falls, any injurious falls and the number of falls were reported 2 years later. The association between polypharmacy (>4 medications) or fall risk-increasing medications and subsequent falls or injurious falls was assessed using modified Poisson regression. The association with the number of falls was assessed using negative binomial regression.
  
  
  RESULTS
  during follow-up, 231 falls per 1,000 person-years were reported. Polypharmacy including antidepressants was associated with a greater risk of any fall (adjusted relative risk (aRR) 1.28, 95% CI 1.06-1.54), of injurious falls (aRR 1.51, 95% CI 1.10-2.07) and a greater number of falls (adjusted incident rate ratio (aIRR) 1.60, 95% CI 1.19-2.15), but antidepressant use without polypharmacy and polypharmacy without antidepressants were not. The use of benzodiazepines was associated with injurious falls when coupled with polypharmacy (aRR 1.40, 95% CI 1.04-1.87), but was associated with a greater number of falls (aIRR 1.32, 95% CI 1.05-1.65), independent of polypharmacy. Other medications assessed, including antihypertensives, diuretics and antipsychotics, were not associated with outcomes.
  
  
  CONCLUSIONS
  in middle-aged and older adults, polypharmacy, including antidepressant or benzodiazepine use, was associated with injurious falls and a greater number of falls.
authors.affiliation: Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland The Irish Longitudinal Study on Ageing, Chemistry Extension Building, Trinity College Dublin, Dublin, Ireland.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Richardson
authors.affiliation: Department of Pharmacology and Therapeutics, Trinity College Dublin, Dublin, Ireland.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Bennett
authors.affiliation: Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
authors.forename: Rose Anne
authors.initials: RA
authors.lastname: Kenny
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000375:Aging; D000928:Antidepressive Agents / Q000009:adverse effects*; D001569:Benzodiazepines / Q000009:adverse effects*; D005260:Female; D006801:Humans; D057187:Independent Living; D007494:Ireland; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019338:Polypharmacy; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000928:Antidepressive Agents; D001569:Benzodiazepines
keywords: drug therapy; falls; older people; polypharmacy