Withdrawal of fall risk-increasing drugs

Abstract

Falls are among the most serious problems faced by older persons and are associated with considerable morbidity and mortality. Falls are multifactorial in origin. Hence, assessment of falls and fall risk is a complex task. An important risk factor for falls is the use of certain drugs, i.e., fall risk-increasing drugs (FRIDs). The exact contribution of FRIDs use to fall risk is not known. To date, information about the effects and effectiveness of FRIDs withdrawal on falls in older persons is scarce. There is evidence that withdrawal of psychotropics reduces rate of falls and that a prescribing modification program for primary care physicians can reduce risk of falling. Withdrawal of all FRIDs, including cardiovascular and psychotropic drugs, appears to be an effective intervention for lowering fall incidence and can lead to improvement of mobility tests and cardiovascular end points. Withdrawal of psychotropics, especially benzodiazepines (BZD), was an important factor in lowering risk of falls requiring medical treatment during the first year after a 12-month multifactorial intervention. BZD withdrawal has also been shown to result in a significant improvement in the stability of the body, a recovery of cognitive functions, and improvement of handgrip strength and balance.