Abstract
BackgroundResults from studies assessing the association between anticholinergic use and falls are mixed, and prior studies are limited in their ability to control for important potential confounders. Thus, we sought to examine the association between anticholinergic medication use, including over-the-counter medications, and recurrent falls in community-dwelling older women.MethodsWe analyzed data from a prospective cohort study of women aged 65 to 79 years from the Women’s Health Initiative Observational Study and Clinical Trials. Women were recruited between 1993 and 1998, and analyses included 61,451 women with complete information. Medications with moderate or strong anticholinergic effects were ascertained directly from drug containers during face-to-face interviews. The main outcome measure was recurrent falls (≥2 falls in previous year), which was determined from self-report within 1.5 years subsequent to the medication assessment.ResultsAt baseline, 11.3 % were using an anticholinergic medication, of which antihistamines (commonly available over-the-counter) were the most common medication class (received by 45.2 % of individuals on anticholinergic medication). Using multivariable GEE models and controlling for potential confounders, the adjusted odds ratio for anticholinergic medication use was 1.51 (95 % CI, 1.43–1.60) for recurrent falls. Participants using multiple anticholinergic medications had a 100 % increase in likelihood of recurrent falls (adjusted odds ratio 2.00, 95 % CI 1.73–2.32). Results were robust to sensitivity analysis.ConclusionsAnticholinergic medication use was associated with increased risk for recurrent falls. Our findings reinforce judicious use of anticholinergic medications in older women. Public health efforts should emphasize educating older women regarding the risk of using over-the-counter anticholinergics, such as first-generation antihistamines.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-016-0251-0) contains supplementary material, which is available to authorized users.
Highlights
Results from studies assessing the association between anticholinergic use and falls are mixed, and prior studies are limited in their ability to control for important potential confounders
The objective of this study was to examine the association between anticholinergic medication use, including over-the-counter medications, and recurrent falls in community-dwelling women
We examined three models: Model 1 was adjusted for linear age at screening, diet modification (DM) trial, and Calcium/vitamin D (CaD) trial randomization arms; Model 2 was adjusted as Model 1, with additional adjustment for race/ethnicity, body mass index, poor vision, arthritis, treated diabetes, low back pain, Alzheimer Disease and/or use of antidementia medication, Parkinson’s Disease, urinary incontinence, depression, insomnia, self-reported health, alcohol intake, use of antiepileptics, and number of psychoactive medications
Summary
Results from studies assessing the association between anticholinergic use and falls are mixed, and prior studies are limited in their ability to control for important potential confounders. We sought to examine the association between anticholinergic medication use, including over-the-counter medications, and recurrent falls in community-dwelling older women. Recurrent falls (as opposed to single falls) may be more clinically important as they may increase the risk of physician. Many of which have central nervous system effects, have been associated with increased risk for falls and fractures [4]. The prevalence of anticholinergic medication use is common with 13–25 % of community-dwelling older adults taking at least one agent [7,8,9]. Anticholinergic medications are considered as potentially inappropriate for use in older adults [10]. Nonpharmacological strategies or alternative medications without anticholinergic effects are often available to treat these specific conditions (e.g., sleep disturbances, urinary incontinence); reducing anticholinergic polypharmacy is feasible
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
