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Atypical Antipsychotic Medications and Risk of Falls in Residents of Aged Care Facilities
Author(s) -
Hien Le T. T.,
Cumming Robert G.,
Cameron Ian D.,
Chen Jian S.,
Lord Stephen R.,
March Lyn M.,
Schwarz Jennifer,
Le Couteur David G.,
Sambrook Philip N.
Publication year - 2005
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2005.53403.x
Subject(s) - medicine , antipsychotic , falls in older adults , poison control , injury prevention , suicide prevention , human factors and ergonomics , geriatrics , polypharmacy , medline , aged care , gerontology , medical emergency , psychiatry , intensive care medicine , schizophrenia (object oriented programming) , political science , law
Objectives: To determine whether use of atypical antipsychotics (olanzapine and risperidone) is associated with lower risk of falls than use of typical antipsychotics. Design: Prospective cohort study with 1‐month follow‐up. Setting: Residential aged care facilities in Sydney, Australia. Participants: Two thousand five people aged 65 to 104 (mean age 86). Measurements: Medication use at baseline was collected from medical records. Data on potential confounders were collected at interview and physical examination and from medical records. The outcome was accidental falls (one or more). Results: One thousand one hundred seven subjects (55%) used at least one type of psychotropic medication, with 289 (14%) using an antipsychotic. There were 82 olanzapine users, 38 risperidone users, and 181 users of typical antipsychotics. Eleven percent of subjects (n=226) had at least one fall during follow‐up. After adjusting for a comprehensive range of falls risk factors, hazard ratios (HRs) for falls were 1.35 (95% confidence interval (CI)=0.87–2.09) for typical antipsychotics, 1.32 (95% CI=0.57–3.06) for risperidone, and 1.74 (95% CI=1.04–2.90) for olanzapine. Antidepressants were also associated with falls (adjusted HR=1.45, 95% CI=1.09–1.93). Conclusion: Despite fewer extrapyramidal side effects, atypical antipsychotic medications are not associated with fewer falls than the older, more‐established antipsychotics.