Associations between fall risk increasing drugs (FRID) and fall & fall injuries in older Black and White men and women: the Health, Aging and Body Composition Study

OBJECTIVES: Use of medications defined as fall risk increasing drugs (FRIDs) have increased in recent years mainly due to antihypertensives, antidepressants, and anticonvulsants. FRIDs and fall injury risk is largely unknown. This study aims to determine if FRIDs use/count, separately considering antihypertensive and other FRIDs use, is associated with non-injurious falls/fall injuries. STUDY DESIGN: We analyzed data from 1273 community-dwelling older Black and White adults in the Health, Aging, and Body Composition Study, a longitudinal cohort (2007-08 visit; 2 years of follow-up; median age = 83 ± 4 years; 54% women; 35% Black). METHODS: Medications used in past 30 days were brought to the visit. The Stopping Elderly Accidents, Deaths & Injuries (STEADI-Rx) definition of FRIDs included any use of 9 medications (yes, N= 1105/1273). Falls/fall injuries were self-reported every 6 months for 2 years. Multivariable generalized estimating equations with first-order autoregressive correlations modeled odds of fall/fall injuries. RESULTS: Antihypertensives were used by 80.6%, with lower use of other FRIDs. Rates were generally higher for fall injury and non-injurious falls vs. no falls (p ≤ 0.05) for antidepressant, anticonvulsant, opioid, antihistamine, and muscle relaxant use. In adjusted models, antihypertensive use entered separately (yes, N= 1026/1273) had no association with fall injury, though other FRIDs use (yes, N= 483/1273; AOR = 1.35; 95%CI: 1.03-1.76) had increased fall injuries and other FRIDs count (AOR = 1.18; 95%CI: 1.06-1.31) had increased non-injurious falls, both vs. no falls. Total STEADI-Rx FRIDs use/count were not associated with fall/fall injuries. CONCLUSIONS: Other FRIDs rather than antihypertensives were associated with increased falls and fall injuries in community-dwelling older adults.