Polypharmacy and injurious falls in older adults: A nationwide nested case-control study
Clinical Epidemiology Jun 27, 2019
Morin L, et al. – In this nested case-control study that used linked register data with national coverage in Sweden, researchers assessed whether the exposure to polypharmacy elevates the risk of fall-related injury among older adults, beyond the effect of fall-risk increasing drugs and chronic multimorbidity. Nearly 50,000 cases were included, with an equally matched number of controls. Adults aged ≥70 years with a history of non-elective admission due to a fall between January 1 and December 31, 2013, were included. For each additional drug, an increase in the risk of injurious falls in a nearly linear fashion was noted. The population attributable portion for injurious falls was 5.2% when a cut-off value of ≥ 4 drugs for explaining polypharmacy was used. Hence, a monotonic dose-response relationship was exhibited between the number of drugs and the risk of injurious fall. Although, the association was substantially more uncertain than previously observed, post-comprehensive adjustment for known confounders (including fall-risk increasing drugs and chronic multimorbidity). Nonetheless, the population attributable risk fraction was low, even if the relationship between polypharmacy and injurious falls was random.
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