Association of fall risk-increasing drugs with falls in generally healthy older adults: a 3-year prospective observational study of the DO-HEALTH trial
Abstract Background The association between fall risk-increasing drugs (FRIDs, medications known to be associated with falls) and the number of falls among generally healthy and active community-dwelling older adults is understudied. Prior studies have focused on individual medication classes or hav...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-11-01
|
| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-024-05557-2 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846147397712871424 |
|---|---|
| author | Caroline de Godoi Rezende Costa Molino Catherine K. Forster Maud Wieczorek E. John Orav Reto W. Kressig Bruno Vellas Andreas Egli Gregor Freystaetter Heike A. Bischoff-Ferrari the DO-HEALTH Research Group |
| author_facet | Caroline de Godoi Rezende Costa Molino Catherine K. Forster Maud Wieczorek E. John Orav Reto W. Kressig Bruno Vellas Andreas Egli Gregor Freystaetter Heike A. Bischoff-Ferrari the DO-HEALTH Research Group |
| author_sort | Caroline de Godoi Rezende Costa Molino |
| collection | DOAJ |
| description | Abstract Background The association between fall risk-increasing drugs (FRIDs, medications known to be associated with falls) and the number of falls among generally healthy and active community-dwelling older adults is understudied. Prior studies have focused on individual medication classes or have predominantly relied on retrospective assessments of falls. The aim of this study was to investigate the association between FRID use at baseline and the prospective incidence rates of total, injurious and recurrent falls in community-dwelling older adults. Methods This is a 3-year observational analysis of DO-HEALTH, a randomized controlled trial, among community-dwelling adults aged ≥ 70 years without major diseases at baseline. The main exposures were use of at least one FRID and multiple FRIDs (≥ 2 FRIDs) at baseline. The number of total falls (including high- and low-trauma falls, as well as injurious falls) over 3 years of follow-up was defined as the primary outcome, and the number of injurious and the number of recurrent total falls (≥ 2 falls), as the two separate secondary outcomes. To examine these associations, separate negative binomial regression models controlled for the fixed effects of treatment allocation in the DO-HEALTH trial, study site, fall in the last year, age, sex, BMI, and walking aid were used. Additionally, an offset of the logarithm of each participant’s time in the study was included in the models. Results A total of 2157 participants were included, with a baseline median age of 74.0 years, 61.7% of whom were women, and 41.9% having experienced a prior fall in the year preceding enrolment. At baseline, 908 (42.1%) participants used at least one FRID, and 351 (16.3%) reported multiple FRIDs use. Prospectively, over 3 years of follow-up, 3333 falls were reported by 1311 (60.8%) out of the 2157 participants. Baseline use of at least one FRID was significantly associated with increased incidence rates of total falls (incidence rate ratio (IRR) [95% Confidence Interval (CI)] = 1.13 [1.01–1.27]), injurious falls (IRR = 1.15 [1.02–1.29]), and recurrent falls (IRR = 1.12 [1.01–1.23]) over 3 years. These associations were most pronounced among users of multiple FRIDs, with increased incidence rates of total falls (IRR = 1.22 [1.05–1.42]), injurious falls (IRR = 1.33 [1.14–1.54]) and recurrent falls (IRR = 1.14 [1.02–1.29]). Conclusion Our results suggest that FRID use is associated with increased prospective incidence rates of total, injurious, and recurrent falls even among generally healthy older adults. Trial registration DO-HEALTH is registered as NCT01745263 on clinicaltrials.gov, with a registration date of 2012-12-06. |
| format | Article |
| id | doaj-art-32219e5e28c440809f77d926c8248e81 |
| institution | Kabale University |
| issn | 1471-2318 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj-art-32219e5e28c440809f77d926c8248e812024-12-01T12:43:43ZengBMCBMC Geriatrics1471-23182024-11-0124111010.1186/s12877-024-05557-2Association of fall risk-increasing drugs with falls in generally healthy older adults: a 3-year prospective observational study of the DO-HEALTH trialCaroline de Godoi Rezende Costa Molino0Catherine K. Forster1Maud Wieczorek2E. John Orav3Reto W. Kressig4Bruno Vellas5Andreas Egli6Gregor Freystaetter7Heike A. Bischoff-Ferrari8the DO-HEALTH Research GroupCentre on Aging and Mobility, University of ZurichCentre on Aging and Mobility, University of ZurichCentre on Aging and Mobility, University of ZurichDepartment of Biostatistics, Harvard TH Chan School of Public HealthUniversity Department of Geriatric Medicine Felix Platter, University of BaselGérontopôle de Toulouse, Institut du Vieillissement, Center Hospitalo- Universitaire de ToulouseCentre on Aging and Mobility, University of ZurichCentre on Aging and Mobility, University of ZurichCentre on Aging and Mobility, University of ZurichAbstract Background The association between fall risk-increasing drugs (FRIDs, medications known to be associated with falls) and the number of falls among generally healthy and active community-dwelling older adults is understudied. Prior studies have focused on individual medication classes or have predominantly relied on retrospective assessments of falls. The aim of this study was to investigate the association between FRID use at baseline and the prospective incidence rates of total, injurious and recurrent falls in community-dwelling older adults. Methods This is a 3-year observational analysis of DO-HEALTH, a randomized controlled trial, among community-dwelling adults aged ≥ 70 years without major diseases at baseline. The main exposures were use of at least one FRID and multiple FRIDs (≥ 2 FRIDs) at baseline. The number of total falls (including high- and low-trauma falls, as well as injurious falls) over 3 years of follow-up was defined as the primary outcome, and the number of injurious and the number of recurrent total falls (≥ 2 falls), as the two separate secondary outcomes. To examine these associations, separate negative binomial regression models controlled for the fixed effects of treatment allocation in the DO-HEALTH trial, study site, fall in the last year, age, sex, BMI, and walking aid were used. Additionally, an offset of the logarithm of each participant’s time in the study was included in the models. Results A total of 2157 participants were included, with a baseline median age of 74.0 years, 61.7% of whom were women, and 41.9% having experienced a prior fall in the year preceding enrolment. At baseline, 908 (42.1%) participants used at least one FRID, and 351 (16.3%) reported multiple FRIDs use. Prospectively, over 3 years of follow-up, 3333 falls were reported by 1311 (60.8%) out of the 2157 participants. Baseline use of at least one FRID was significantly associated with increased incidence rates of total falls (incidence rate ratio (IRR) [95% Confidence Interval (CI)] = 1.13 [1.01–1.27]), injurious falls (IRR = 1.15 [1.02–1.29]), and recurrent falls (IRR = 1.12 [1.01–1.23]) over 3 years. These associations were most pronounced among users of multiple FRIDs, with increased incidence rates of total falls (IRR = 1.22 [1.05–1.42]), injurious falls (IRR = 1.33 [1.14–1.54]) and recurrent falls (IRR = 1.14 [1.02–1.29]). Conclusion Our results suggest that FRID use is associated with increased prospective incidence rates of total, injurious, and recurrent falls even among generally healthy older adults. Trial registration DO-HEALTH is registered as NCT01745263 on clinicaltrials.gov, with a registration date of 2012-12-06.https://doi.org/10.1186/s12877-024-05557-2FallsFall risk-increasing drugsProspective studyLongitudinal studyCommunity-dwelling older adultsDO-HEALTH |
| spellingShingle | Caroline de Godoi Rezende Costa Molino Catherine K. Forster Maud Wieczorek E. John Orav Reto W. Kressig Bruno Vellas Andreas Egli Gregor Freystaetter Heike A. Bischoff-Ferrari the DO-HEALTH Research Group Association of fall risk-increasing drugs with falls in generally healthy older adults: a 3-year prospective observational study of the DO-HEALTH trial BMC Geriatrics Falls Fall risk-increasing drugs Prospective study Longitudinal study Community-dwelling older adults DO-HEALTH |
| title | Association of fall risk-increasing drugs with falls in generally healthy older adults: a 3-year prospective observational study of the DO-HEALTH trial |
| title_full | Association of fall risk-increasing drugs with falls in generally healthy older adults: a 3-year prospective observational study of the DO-HEALTH trial |
| title_fullStr | Association of fall risk-increasing drugs with falls in generally healthy older adults: a 3-year prospective observational study of the DO-HEALTH trial |
| title_full_unstemmed | Association of fall risk-increasing drugs with falls in generally healthy older adults: a 3-year prospective observational study of the DO-HEALTH trial |
| title_short | Association of fall risk-increasing drugs with falls in generally healthy older adults: a 3-year prospective observational study of the DO-HEALTH trial |
| title_sort | association of fall risk increasing drugs with falls in generally healthy older adults a 3 year prospective observational study of the do health trial |
| topic | Falls Fall risk-increasing drugs Prospective study Longitudinal study Community-dwelling older adults DO-HEALTH |
| url | https://doi.org/10.1186/s12877-024-05557-2 |
| work_keys_str_mv | AT carolinedegodoirezendecostamolino associationoffallriskincreasingdrugswithfallsingenerallyhealthyolderadultsa3yearprospectiveobservationalstudyofthedohealthtrial AT catherinekforster associationoffallriskincreasingdrugswithfallsingenerallyhealthyolderadultsa3yearprospectiveobservationalstudyofthedohealthtrial AT maudwieczorek associationoffallriskincreasingdrugswithfallsingenerallyhealthyolderadultsa3yearprospectiveobservationalstudyofthedohealthtrial AT ejohnorav associationoffallriskincreasingdrugswithfallsingenerallyhealthyolderadultsa3yearprospectiveobservationalstudyofthedohealthtrial AT retowkressig associationoffallriskincreasingdrugswithfallsingenerallyhealthyolderadultsa3yearprospectiveobservationalstudyofthedohealthtrial AT brunovellas associationoffallriskincreasingdrugswithfallsingenerallyhealthyolderadultsa3yearprospectiveobservationalstudyofthedohealthtrial AT andreasegli associationoffallriskincreasingdrugswithfallsingenerallyhealthyolderadultsa3yearprospectiveobservationalstudyofthedohealthtrial AT gregorfreystaetter associationoffallriskincreasingdrugswithfallsingenerallyhealthyolderadultsa3yearprospectiveobservationalstudyofthedohealthtrial AT heikeabischoffferrari associationoffallriskincreasingdrugswithfallsingenerallyhealthyolderadultsa3yearprospectiveobservationalstudyofthedohealthtrial AT thedohealthresearchgroup associationoffallriskincreasingdrugswithfallsingenerallyhealthyolderadultsa3yearprospectiveobservationalstudyofthedohealthtrial |