title: Use of Medications with Anticholinergic Activity and Self-Reported Injurious Falls in Older Community-Dwelling Adults.
abstract: OBJECTIVE
  To assess the association between the use of medications with anticholinergic activity and the subsequent risk of injurious falls in older adults.
  
  
  METHODS
  Prospective, population-based study using data from The Irish Longitudinal Study on Ageing.
  
  
  METHODS
  Irish population.
  
  
  METHODS
  Community-dwelling men and women without dementia aged 65 and older (N = 2,696).
  
  
  METHODS
  Self-reported injurious falls reported once approximately 2 years after baseline interview. Self-reported regular medication use at baseline interview. Pharmacy dispensing records from the Irish Health Service Executive Primary Care Reimbursement Service in a subset (n = 1,553).
  
  
  RESULTS
  Nine percent of men and 17% of women reported injurious falls. In men, the use of medications with definite anticholinergic activity was associated with greater risk of subsequent injurious falls (adjusted relative risk (aRR) = 2.55, 95% confidence interval (CI) = 1.33-4.88), but the risk of having any fall and the number of falls reported were not significantly greater. Greater anticholinergic burden was associated with greater injurious falls risk. No associations were observed for women. Findings were similar using pharmacy dispensing records. The aRR for medications with definite anticholinergic activity dispensed in the month before baseline and subsequent injurious falls in men was 2.53 (95% CI = 1.15-5.54).
  
  
  CONCLUSIONS
  The regular use of medications with anticholinergic activity is associated with subsequent injurious falls in older men, although falls were self-reported after a 2-year recall and so may have been underreported. Further research is required to validate this finding in men and to consider the effect of duration and dose of anticholinergic medications.
authors.affiliation: Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland.|School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Richardson
authors.affiliation: Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St. James' Hospital, Dublin, Ireland.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Bennett
authors.affiliation: School of Life and Health Sciences, University of Aston, Birmingham, UK.|Aston Research Centre for Healthy Ageing, University of Aston, Birmingham, UK.
authors.forename: Ian D
authors.initials: ID
authors.lastname: Maidment
authors.affiliation: Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Fox
authors.affiliation: Princess Royal University Hospital, King's College National Health Service Foundation Trust, London, UK.|Department of Digital Arts and Electronics, University of Kent, Canterbury, UK.
authors.forename: David
authors.initials: D
authors.lastname: Smithard
authors.affiliation: Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland.|Trinity College Institute of Neuroscience, St. James' Hospital, Dublin, Ireland.
authors.forename: Rose Anne
authors.initials: RA
authors.lastname: Kenny
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D018680:Cholinergic Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D003704:Dementia / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D015994:Incidence; D007494:Ireland / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000139:chemically induced* / Q000453:epidemiology
chemical_list: D018680:Cholinergic Antagonists
keywords: anticholinergic; antimuscarinic; elderly; falls; injury