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• More than 11 million seniors—one of every three—will fall this year (Sattin 1992; Tinetti, Speechley, and Ginter 1988), and approximately one in 10 of those falls will result in a serious injury such as hip fracture or head injury (Tinnetti 2003). More than 500,000 seniors will suffer hip fractures annually by 2040 (Cummings, Rubin, and Black 1990).

• Each year, 35% to 40% of generally healthy seniors living in the community fall (Campbell, Spears, and Borrie 1990). Because nursing facility residents are older, more frail, and more cognitively-impaired, approximately 50% fall each year (Rubinstein, Josephson, and Robbins 1994).

• About 20% of hip fracture patients will die within five years of the fracture (Cooper 1997), yet thousands of those deaths are PREVENTABLE.

  “No risk factor for falls is as potentially preventable or reversible as medication use.” (Leipzig, Cumming, and Tinetti 1999)

• Most people do not realize that falls can be a medication-related problem.

• Risk factors for falls include medication use, advanced age, decreased mobility and strength, balance impairment, neurological disease, cardiovascular disease, incontinence, visual impairment and cognitive impairment.

• Certain medications—such as high blood pressure medications, antidepressants, sleep aids, anti-seizure medications, and heart antiarrythmic medications—can contribute to falls in the elderly for a variety of different reasons. Perhaps a drug causes dizziness in an elderly patient, and that patient has not been properly instructed on how to rise and walk while on the medication. Standing up too quickly could result in a fall. Or, perhaps a drug causes frequent urination, and a patient constantly gets up during the night. One of those bathroom trips could cause a fall, and possibly a hip fracture.

Medication-related falls and hip fractures are preventable

Senior care pharmacists can assess seniors’ drug regimens for exposure to risks that may contribute to falls, recommend drug therapy changes, and educate the patient and caregiver on how to avoid dangerous situations. Medication management is an effective fall prevention measure (Cooper 1997).

You can find a senior care pharmacist in our online directory of senior care pharmacists from across the U.S. and Canada, who have expertise in geriatrics, geriatric pharmacotherapy, and the unique medication-related needs of older adults.

References
Campbell A. J., Spears G.F., Borrie M.J. Examination by logistic regression modelling of the variables which
increase the relative risk of elderly women falling compared to eldery men. J Clin Epidemiol
1990;43:1415–20.

Cooper J. W. Reducing falls among patients in nursing homes. JAMA 1997;278:1742.

Cummings S. R., Rubin S.M., Black D. The future of hip fractures in the United States. Numbers, costs,
and potential effects of postmenopausal estrogen. Clinical Orthopaedics and Related Research
1990;252:163–6.

Leipzig R. M., Cumming R. G., Tinetti M. E. Drugs and falls in older people: a systematic review and meta-
analysis: I. Psychotropic drugs. J Am Geriatr Soc 1999;47:30–39.

Rubinstein L. Z., Josephson K. R., Robbins A. Falls in the nursing home. Ann Int Med 1994;121:442–51.
Sattin R. W. Falls among older persons: A public health perspective. Annual Review of Public Health
1992;13:489–508.

Tinetti M. E., Speechley M., Ginter S. F. Risk factors for falls among elderly persons living in the commu-
nity. N Eng J Med 1988;319(26):1701–7.

Tinetti M.E., Preventing falls in elderly persons. N.Eng J Med 2003; 348(1):42–9.

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