Psychotropic drugs and falling accidents among the elderly: a nested case control study in the whole population of Scania, Sweden

Study objective The objective of this study was to investigate the associations between medication with psychotropic drugs and falling accidents in the whole population aged 65 years and older in the county of Scania, Sweden. Design A population based nested case control study was performed. Subjects Cases were persons registered in the Region Healthcare database after a falling accident during the year 2006 (n = 10 482). One control was matched to each case based on age, sex, date of the falling accident, living area and propensity score (based on prevalent disease). Main results Using psychotropic drugs within 3 months before the fall was associated with a more than doubled odds for a falling accident among both men (2.14, 95% CI 1.87 to 2.44) and women (2.21, 95% CI 2.04 to 2.39). The use of psychotropic drugs during the week before the accident occurred was associated with an even higher odds for a falling accident among both men (OR 5.61; 95% CI 2.54 to 12.41) and women (OR 3.40; 95% CI 2.24 to 5.17). A similar pattern of association was seen for specific groups of psychotropic drugs: opioids, antidepressants and anxiolytics/hypnotics/sedatives. Conclusions The use of psychotropic drugs increased the odds for a falling accident among persons 65 years and older. Generally, patients using psychotropic drugs seemed to have the highest odds for falling accidents immediately after initiating therapy. Since these medications are extensively used among the elderly, the increased risk for falls associated with these kinds of drugs is an important public health problem that could be tackled by a more rational medication use.