Psychotropic drugs and the risk of fall injuries, hospitalisations and mortality among older adults.
To investigate whether psychotropics are associated with an increased risk of fall injuries, hospitalizations, and mortality in a large general population of older adults.



We performed a nationwide matched (age, sex, and case event day) case-control study between 1 January and 31 December 2011 based on several Swedish registers (n = 1,288,875 persons aged ≥65 years). We used multivariate conditional logistic regression adjusted for education, number of inpatient days, Charlson co-morbidity index, dementia and number of other drugs.



Antidepressants were the psychotropic most strongly related to fall injuries (ORadjusted: 1.42; 95% CI: 1.38-1.45) and antipsychotics to hospitalizations (ORadjusted: 1.22; 95% CI: 1.19-1.24) and death (ORadjusted: 2.10; 95% CI: 2.02-2.17). Number of psychotropics was associated with increased the risk of fall injuries, (4 psychotropics vs 0: ORadjusted: 1.53; 95% CI: 1.39-1.68), hospitalization (4 psychotropics vs 0: ORadjusted: 1.27; 95% CI: 1.22-1.33) and death (4 psychotropics vs 0: ORadjusted: 2.50; 95% CI: 2.33-2.69) in a dose-response manner. Among persons with dementia (n = 58,984), a dose-response relationship was found between number of psychotropics and mortality risk (4 psychotropics vs 0: ORadjusted: 1.99; 95% CI: 1.76-2.25).



Our findings support a cautious prescribing of multiple psychotropic drugs to older patients. © 2016 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons, Ltd.
Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
Kristina
K
Johnell
The Swedish National Board of Health and Welfare (Socialstyrelsen), Stockholm, Sweden.
Gudrun
G
Jonasdottir Bergman
Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.|The Swedish National Board of Health and Welfare (Socialstyrelsen), Stockholm, Sweden.
Johan
J
Fastbom
The Swedish National Board of Health and Welfare (Socialstyrelsen), Stockholm, Sweden.
Bengt
B
Danielsson
The Swedish National Board of Health and Welfare (Socialstyrelsen), Stockholm, Sweden.
Natalia
N
Borg
The Swedish National Board of Health and Welfare (Socialstyrelsen), Stockholm, Sweden.
Peter
P
Salmi
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D009026:Mortality; D011619:Psychotropic Drugs / Q000009:adverse effects* / Q000627:therapeutic use; D013548:Sweden / Q000453:epidemiology
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D011619:Psychotropic Drugs
Sweden; aged; dementia; psychotropic drugs