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Many common drugs increase seniors’ chances of falling
If you have elderly family members or friends on any medications, it would be a good idea to check what those medications are and what dosages they are.
A new study shows that at the usual dosage recommended for younger people, a long list of common medications places seniors at a higher risk of falling and hurting themselves than elderly people not taking those drugs.
Part of the problem is that many doctors are prescribing the drugs at dosages recommended only for younger patients, not the reduced dosages recommended for the elderly. Also, the risk of falling also increases just by taking more of those drugs on the list than others, even at the proper dosage.
The study, by geriatric and medical specialists in New York City, found that a long list of very common medications are causing the problem – benzodiazepines, benzodiazepine-receptor agonists (BRAs), sleep medications, muscle relaxants and antipsychotics – all commonly administered to elderly patients. And all increase the risk of falling, especially at the incorrect higher dosages.
Published in the Journal of the American Geriatrics Society, the study involved a small group of 287 elderly patients over age 65 who had experienced falls while hospitalized in an urban academic medical center – many of them falling more than once.
Out of a total of 328 falls, 62 percent of them occurred in patients taking at least one of the high-risk medications within 24 hours before the fall. Sixteen percent of the falls involved individuals receiving two of those drugs, and another 16 percent had received three or more. All falls occurred more often among those taking the drugs than those not taking them.
The high-risk medications most often administered at higher-than-recommended geriatric daily doses were in the benzodiazepine family (e.g., Xanax, Klonopin). Dangerously high doses were administered in over 57 percent of cases. And the test hospital’s default doses were set at higher than recommended for 12 of the 29 medications examined.
The study authors suggest that simple interventions that could decrease inpatient falls include a) prescribers decreasing the doses for all 29 drugs on the danger list to match those recommended for patients over 65; and b) patients and physicians should be warned that “the cumulative numbers of high-risk medications prescribed per person” is also a risk factor, even at the reduced dosages.
An article in Medscape more than a year ago reveals that much of this study data was already known. A doctor at the Centers for Disease Control and Prevention wrote:
“Medication management works by reducing interactions and side effects that may lead to falls. Effectively managing medications includes eliminating medications if there is no active indication, reducing doses of necessary medications to the lowest effective dose, and
avoiding prescribing medications for older people in whom the risk from side effects outweighs the benefits of the drug.
“Many medications have been linked to falls. However, three types of medications that you should immediately consider reducing or eliminating among your older adult patients include psychoactive medications (especially benzodiazepines), medications with anticholinergic (muscle relaxant/paralytic) side effects, and sedatives that can be purchased over-the-counter, such as Tylenol PM and Benadryl.”
The best solution would be to entirely eliminate all drugs that are not medically necessary. Countless nursing home patients are placed on one or more dangerous drugs when there is no medical reason for doing so – as outrageously non-medical as just trying to shut them up because they’re annoying the nurses or other patients.
Another factor not mentioned by the researchers, but certainly well known to us here at Novus, is that many of these drugs are addictive, especially the opioid painkillers and benzodiazepines. And many of these drugs are also dangerous if they’re abruptly discontinued after they’ve been taken for a while, some as briefly as a week or two.
Here’s the bottom line:
If there’s an elderly person you care about, or someone you know has elderly family or friends, tip them off to the data in this study. Urge them to check up on the drugs and tell them to insist that the doctors verify correct doses for the elderly.
And also ask the doctors to verify that the patient is not becoming dependent.
You could be saving a life.
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