Polypharmacy is a risk factor for hospital admission due to a fall: evidence from the english longitudinal study of ageing

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 t...

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Autores: Zaninotto, Paola, Huang, Yu-Te, Di Gessa, Giorgio, Abell, Jessica, Lassale, Camille, Steptoe, Andrew
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/47681
Acceso en línea:http://hdl.handle.net/10230/47681
http://dx.doi.org/10.1186/s12889-020-09920-x
Access Level:acceso abierto
Palabra clave:Falls
Hospitalization
Older people
Polypharmacy
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spelling Polypharmacy is a risk factor for hospital admission due to a fall: evidence from the english longitudinal study of ageingZaninotto, PaolaHuang, Yu-TeDi Gessa, GiorgioAbell, JessicaLassale, CamilleSteptoe, AndrewFallsHospitalizationOlder peoplePolypharmacyBackground: 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.BioMed Central202120212020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/47681http://dx.doi.org/10.1186/s12889-020-09920-xreponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésCopyright © The Author(s) 2020. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies tohttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/476812026-06-12T07:21:37Z
dc.title.none.fl_str_mv Polypharmacy is a risk factor for hospital admission due to a fall: evidence from the english longitudinal study of ageing
title Polypharmacy is a risk factor for hospital admission due to a fall: evidence from the english longitudinal study of ageing
spellingShingle Polypharmacy is a risk factor for hospital admission due to a fall: evidence from the english longitudinal study of ageing
Zaninotto, Paola
Falls
Hospitalization
Older people
Polypharmacy
title_short 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_sort Polypharmacy is a risk factor for hospital admission due to a fall: evidence from the english longitudinal study of ageing
dc.creator.none.fl_str_mv Zaninotto, Paola
Huang, Yu-Te
Di Gessa, Giorgio
Abell, Jessica
Lassale, Camille
Steptoe, Andrew
author Zaninotto, Paola
author_facet Zaninotto, Paola
Huang, Yu-Te
Di Gessa, Giorgio
Abell, Jessica
Lassale, Camille
Steptoe, Andrew
author_role author
author2 Huang, Yu-Te
Di Gessa, Giorgio
Abell, Jessica
Lassale, Camille
Steptoe, Andrew
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Falls
Hospitalization
Older people
Polypharmacy
topic Falls
Hospitalization
Older people
Polypharmacy
description 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.
publishDate 2020
dc.date.none.fl_str_mv 2020
2021
2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/47681
http://dx.doi.org/10.1186/s12889-020-09920-x
url http://hdl.handle.net/10230/47681
http://dx.doi.org/10.1186/s12889-020-09920-x
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
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application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
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