Buffalo, NY—Prescribing drugs to older adults that increase their risk of falling is almost universal, according to a new study that notes the trend appears concurrent with a steep increase in deaths related to falls among elderly Americans.

The report in Pharmacoepidemiology and Drug Safety asserts that nearly every older adult in their research was prescribed at least one prescription drug in that category during a 2017 study period.

In fact, University at Buffalo–led researchers determined that the percentage of adults aged 65 years and older who were prescribed a drug heightening their fall risk rose to 94% in 2017, compared with 57% in 1999. The study team also advises that the rate of death caused by falls in older adults more than doubled during the same time period.

The concern, they write, is that even minor falls may be dangerous for older adults. Injuries such hip fractures and head traumas can significantly lower remaining quality of life, and the annual cost to the healthcare system reaches nearly $50 billion, according to the CDC.

“Our study indicates two trends increasing concurrently at a population level that should be examined at the individual level,” explained lead investigator Amy Shaver, PharmD, a postdoctoral associate in the university’s School of Public Health and Health Professions.

The authors cite previous studies documenting increasing mortality related to falls among older adults, adding that they sought to determine whether there was an increase in drug prescribing linked to fall risk and whether it was concurrent with the rise in fall‐related mortality among older adults in the United States.

To do that, the study team conducted a serial cross‐sectional analysis using data from both the National Vital Statistics System (NVSS) and the medical-expenditure panel survey (MEPS) for years 1999–2017. Researchers evaluated adults aged 65 years and older for deaths due to falls from the NVSS and for prescription fills of fall-risk–increasing drugs per the Stopping Elderly Accidents, Deaths, and Injuries‐Rx fall checklist from the MEPS.

Included in the analysis from 1999 to 2017 were 374, 972 fall‐related mortalities and more than 7.8 billion fills of fall-risk–increasing drugs. The study determined that more than 560 million adults aged 65 years and older received at least one fall-risk–increasing drug. At the same time, age‐adjusted mortality due to falls increased from 29.40 per 100,000 in 1999 to 63.27 per 100,000 in 2017.

“Both use of fall risk increasing drugs and mortality due to falls are on the rise,” the authors wrote. “Fall risk increasing drugs may partially explain the increase in mortality due to falls; this cannot be firmly concluded from the current study. Future research examining the potential relationship between fall risk increasing drugs and fall‐related mortality utilizing nationally representative person‐level data are needed.”

While most of the prescriptions in question were for antihypertensives, researchers also pointed to a steep rise in the use of antidepressants, from 12 million prescriptions in 1999 to more than 52 million in 2017.

“The rise in the use of antidepressant medications seen in this study is likely related to the use of these agents as safer alternatives to older medications for conditions such as depression and anxiety,” Dr. Shaver said. “However, it is important to note that these medications are still associated with increased risks of falls and fractures among older adults.”

Women were determined to be more likely than men to be prescribed fall-risk-increasing drugs, with Black women receiving those medications at the highest rate compared with women of other races. The largest increase in deaths from falls, rising 160% between 1999 and 2017, occurred in white women who were aged 85 years and older.

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