Image of an older women with walker in long-term care setting interacting with healthcare provider

The percentage of older adults prescribed drugs that increase falls risk shot from 57% to 94% over almost two decades, according to new findings.

Not only did these prescriptions increase between 1999 and 2017, but the rate of death caused by falls in older adults more than doubled in the same time period, reported investigators from the University at Buffalo, in New York.

During the study period, more than 7.8 billion fall-risk-increasing drug orders were filled by adults aged 65 years and older in the United States. Most were for antihypertensives, but a sharp rise also was seen in the use of antidepressants — from 12 million prescriptions in 1999 to more than 52 million in 2017, the researchers wrote. 

The rise in antidepressant prescriptions may be due to their use as safer alternatives to older medications for conditions such as depression and anxiety, said study lead Amy Shaver, PharmD. “However, it is important to note that these medications are still associated with increased risks of falls and fractures among older adults,” she added.

Women, especially Black women, were found to be more likely than men to be prescribed fall-risk-increasing drugs. White women aged 85 years and older, meanwhile, accounted for the largest increase in deaths from falls, with rates rising 160% between 1999 and 2017.

The two trends now occurring at a population level should be examined at the individual level, Shaver suggested. “Our hope is it will start more conversations on healthcare teams about the pros and cons of medications prescribed for vulnerable populations,” she said.

Drugs known to increase falls risk include antidepressants, anticonvulsants, antipsychotics, high blood pressure medications, opioids, sedative hypnotics, and benzodiazepines (such as Valium and Xanax), as well as some over-the-counter medications.

Each year, fall injuries among older adults account for almost $50 billion in medical costs, according to the Centers for Disease Control and Prevention.

The study was published in the journal Pharmacoepidemiology and Drug Safety.