Polypharmacy is a risk factor for hospital admission due to a fall: evidence from the English Longitudinal Study of Ageing
Abstract Background Falls amongst older people are common; however, around 40% of falls could be preventable. Medications are known to increase the risk of falls in older adults. The debate about reducing the number of prescribed medications remains controversial, and more evidence is needed to unde...
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| Format: | Article |
| Language: | English |
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BMC
2020-11-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12889-020-09920-x |
| _version_ | 1819052993042972672 |
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| author | P. Zaninotto Y. T. Huang G. Di Gessa J. Abell C. Lassale A. Steptoe |
| author_facet | P. Zaninotto Y. T. Huang G. Di Gessa J. Abell C. Lassale A. Steptoe |
| author_sort | P. Zaninotto |
| collection | DOAJ |
| description | Abstract Background Falls amongst older people are common; however, around 40% of falls could be preventable. Medications are known to increase the risk of falls in older adults. The debate about reducing the number of prescribed medications remains controversial, and more evidence is needed to understand the relationship between polypharmacy and fall-related hospital admissions. We examined the effect of polypharmacy on hospitalization due to a fall, using a large nationally representative sample of older adults. Methods Data from the English Longitudinal Study of Ageing (ELSA) were used. We included 6220 participants aged 50+ with valid data collected between 2012 and 2018.The main outcome measure was hospital admission due to a fall. Polypharmacy -the number of long-term prescription drugs- was the main exposure coded as: no medications, 1–4 medications, 5–9 medications (polypharmacy) and 10+ medications (heightened polypharmacy). Competing-risk regression analysis was used (with death as a potential competing risk), adjusted for common confounders, including multi-morbidity and fall risk-increasing drugs. Results The prevalence of people admitted to hospital due to a fall increased according to the number of medications taken, from 1.5% of falls for people reporting no medications, to 4.7% of falls among those taking 1–4 medications, 7.9% of falls among those with polypharmacy and 14.8% among those reporting heightened polypharmacy. Fully adjusted SHRs for hospitalization due to a fall among people who reported taking 1–4 medications, polypharmacy and heightened polypharmacy were 1.79 (1.18; 2.71), 1.75 (1.04; 2.95), and 3.19 (1.61; 6.32) respectively, compared with people who were not taking medications. Conclusions The risk of hospitalization due to a fall increased with polypharmacy. It is suggested that prescriptions in older people should be revised on a regular basis, and that the number of medications prescribed be kept to a minimum, in order to reduce the risk of fall-related hospital admissions. |
| first_indexed | 2024-12-21T12:28:39Z |
| format | Article |
| id | doaj.art-b61590f1eb7f4675b39ae5d767f93770 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-21T12:28:39Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-b61590f1eb7f4675b39ae5d767f937702022-12-21T19:04:06ZengBMCBMC Public Health1471-24582020-11-012011710.1186/s12889-020-09920-xPolypharmacy is a risk factor for hospital admission due to a fall: evidence from the English Longitudinal Study of AgeingP. Zaninotto0Y. T. Huang1G. Di Gessa2J. Abell3C. Lassale4A. Steptoe5Department of Epidemiology and Public Health, University College LondonDepartment of Epidemiology and Public Health, University College LondonDepartment of Epidemiology and Public Health, University College LondonDepartment of Behavioral Science and Health, University College LondonDepartment of Epidemiology and Public Health, University College LondonDepartment of Behavioral Science and Health, University College LondonAbstract Background Falls amongst older people are common; however, around 40% of falls could be preventable. Medications are known to increase the risk of falls in older adults. The debate about reducing the number of prescribed medications remains controversial, and more evidence is needed to understand the relationship between polypharmacy and fall-related hospital admissions. We examined the effect of polypharmacy on hospitalization due to a fall, using a large nationally representative sample of older adults. Methods Data from the English Longitudinal Study of Ageing (ELSA) were used. We included 6220 participants aged 50+ with valid data collected between 2012 and 2018.The main outcome measure was hospital admission due to a fall. Polypharmacy -the number of long-term prescription drugs- was the main exposure coded as: no medications, 1–4 medications, 5–9 medications (polypharmacy) and 10+ medications (heightened polypharmacy). Competing-risk regression analysis was used (with death as a potential competing risk), adjusted for common confounders, including multi-morbidity and fall risk-increasing drugs. Results The prevalence of people admitted to hospital due to a fall increased according to the number of medications taken, from 1.5% of falls for people reporting no medications, to 4.7% of falls among those taking 1–4 medications, 7.9% of falls among those with polypharmacy and 14.8% among those reporting heightened polypharmacy. Fully adjusted SHRs for hospitalization due to a fall among people who reported taking 1–4 medications, polypharmacy and heightened polypharmacy were 1.79 (1.18; 2.71), 1.75 (1.04; 2.95), and 3.19 (1.61; 6.32) respectively, compared with people who were not taking medications. Conclusions The risk of hospitalization due to a fall increased with polypharmacy. It is suggested that prescriptions in older people should be revised on a regular basis, and that the number of medications prescribed be kept to a minimum, in order to reduce the risk of fall-related hospital admissions.http://link.springer.com/article/10.1186/s12889-020-09920-xOlder peoplePolypharmacyFallsHospitalization |
| spellingShingle | P. Zaninotto Y. T. Huang G. Di Gessa J. Abell C. Lassale A. Steptoe Polypharmacy is a risk factor for hospital admission due to a fall: evidence from the English Longitudinal Study of Ageing BMC Public Health Older people Polypharmacy Falls Hospitalization |
| title | Polypharmacy is a risk factor for hospital admission due to a fall: evidence from the English Longitudinal Study of Ageing |
| title_full | Polypharmacy is a risk factor for hospital admission due to a fall: evidence from the English Longitudinal Study of Ageing |
| title_fullStr | Polypharmacy is a risk factor for hospital admission due to a fall: evidence from the English Longitudinal Study of Ageing |
| title_full_unstemmed | Polypharmacy is a risk factor for hospital admission due to a fall: evidence from the English Longitudinal Study of Ageing |
| title_short | Polypharmacy is a risk factor for hospital admission due to a fall: evidence from the English Longitudinal Study of Ageing |
| title_sort | polypharmacy is a risk factor for hospital admission due to a fall evidence from the english longitudinal study of ageing |
| topic | Older people Polypharmacy Falls Hospitalization |
| url | http://link.springer.com/article/10.1186/s12889-020-09920-x |
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