Medications and the risk of falls and fractures

Over the past ten years Professor Cumming has conducted several studies of the relationship between use of medications and the risk of falls and fractures in older people. He has also been involved in meta-analyses in this area. The most consistent finding is that psychotropic medications increase the risk of falls and fractures in older people.

Benzodiazepines and risk of hip fractures in older people

More recently, Professors Le Couteur and Cumming have examined the use of psychotropic medications as a risk factor for hip fracture. They reviewed epidemiological studies of the relationship between use of benzodiazepines and risk of hip fracture and, then, looked at the results of these studies to see how they fit with what is known about the pharmacology of benzodiazepines.

The epidemiological evidence strongly suggests that the use of benzodiazepines by older people increases their risk of hip fracture by at least 50%. The benefits of benzodiazepines for older people are unclear. Given the high morbidity and mortality of hip fracture, it can be concluded that older people should rarely be prescribed benzodiazepines and that many older people already taking these drugs should have them withdrawn under appropriate supervision.

Publications

A listing of published research papers dealing with medications, sight imparement and falls follows:

• Benzodiazepines and risk of hip fractures in older people: a review of the evidence. Cumming RG, Le Couteur DG. CNS Drugs. 2003;17(11):825-37.
  To view the abstract for this paper, link here


• Epidemiology of medication-related falls and fractures in the elderly. Cumming RG. Drugs Aging. 1998 Jan;12(1):43-53.
  To view the abstract for this paper, link here


• Associations between elevated intraocular pressure and glaucoma, use of glaucoma medications, and 5-year incident cataract: the Blue Mountains Eye Study. Chandrasekaran S, Cumming RG, Rochtchina E, Mitchell P. Ophthalmology. 2006 Mar;113(3):417-24. Epub 2006 Feb 3.
  To view the abstract for this paper, link here
  For more information about the Blue Mountain Eye Study, link here


• Atypical antipsychotic medications and risk of falls in residents of aged care facilities. Hien le TT, Cumming RG, Cameron ID, Chen JS, Lord SR, March LM, Schwarz J, Le Couteur DG, Sambrook PN. Am Geriatr Soc. 2005 Aug;53(8):1290-5
  To view the abstract for this paper, link here


• Is medication use associated with the incidence of early age-related maculopathy? Pooled findings from 3 continents. van Leeuwen R, Tomany SC, Wang JJ, Klein R, Mitchell P, Hofman A, Klein BE, Vingerling JR, Cumming RG, de Jong PT. Ophthalmology. 2004 Jun;111(6):1169-75
  To view the abstract for this paper, link here .