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Nursing Home Dementia Patients Three Times as Likely to Fall if on Antidepressants

Selective serotonin reuptake inhibitors (SSRIs) appear to cause risk to rise with higher doses

Jan. 19, 2012 - Nursing home residents with dementia who use average doses of selective serotonin reuptake inhibitors (SSRIs) are three times more likely to have an injurious fall than similar people who don’t use these drugs.

The association can be seen in people who use low doses of SSRIs and the risk increases as people take higher doses. The results are published in the British Journal of Clinical Pharmacology.

Many nursing home residents with dementia suffer from depression, and are therefore treated with antidepressants. Selective serotonin reuptake inhibitors (SSRIs) are generally considered the treatment of choice.


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Links to archived reports on senior citizens and fall, see below news report.

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“Our study also discovered that the risk of an injurious fall increased even more if the residents were also given hypnotic or sedative drugs as sleeping pills,” said lead author Carolyn Shanty Sterke, who works in the Section of Geriatric Medicine at Erasmus University Medical Center, Rotterdam, The Netherlands.

Falls are a major health problem in nursing home residents with dementia. In nursing homes one-third of all falls result in an injury. “Physicians should be cautious in prescribing SSRIs to older people with dementia, even at low doses,” says Sterke.

Sterke carried out this research by recording the daily drug use and daily falls in 248 nursing home residents with dementia from 1 January 2006 until 1 January 2008.

Data about the residents’ day-by day drug use came from a prescription database, and information on falls and subsequent injuries came from a standardised incident report system. In total, she had collected a dataset of 85,074 person-days.

The mean age of the participants was 82 years, and the prescription records showed that antidepressants had been used on 13,729 (16.1%) days, with SSRIs being used on 11,105 of these days.


   ● The incident reports showed that 152 of the 248 residents (61.5%) sustained 683 falls.

   ● This corresponds to a fall incidence of 2.9 falls per person-year.

  ● Thirty-eight residents had a single fall, but 114 fell frequently.

   ● Two hundred twenty falls resulted in injury or death.

   ● Of these 10 were hip fractures, 11 were other fractures and 198 were injuries such as grazes, open wounds, sprains, bruises, and swellings.

   ● One person died after falling.

The risk of having an injurious fall increased threefold for residents taking SSRIs, from an absolute daily risk of 0.09% for a female aged 80 not taking an SSRI, to 0.28% for a female aged 80 taking one defined daily dose of SSRIs. Similar increases in absolute daily risk were found for both men and women, for different ages.

“Staff in residential homes are always concerned about reducing the chance of people falling and I think we should consider developing new treatment protocols that take into account the increased risk of falling that occurs when you give people SSRIs,” says Sterke.

Links to Archived Reports on Senior Citizens and Risk of Falls

Exercising to Piano Music Appears to Help Reduce Falls Among Senior Citizens

Program may help fall prevention and rehabilitation in community-based setting such as senior centers - Nov. 23, 2010

Even Short Falls Can Be Deadly For Senior Citizens Age 70 and Older

These elderly people are three times as likely to die following low-level falls

 - Nov. 1, 2010

Failing to Take Medications Regularly as Prescribed Increases Falls by Senior Citizens

Health care providers should discuss this subject with their patients - May 19, 2010

Osteoporosis Drug, Forteo, Appears to Heal Common Injury to Senior Citizens From Falls

Newly approved drug improves healing after rotator cuff surgery; common problem for falling seniors and young athletes - March 10, 2010

Elderly Women Right Up There with Young Male Athletes in a Risk of Shoulder Dislocation

New reports has more evidence of the serious consequences of falls by senior citizens – women in particular - March 1, 2010

Falls by Senior Citizens Caused by Poor Central and Side Vision, Study Finds

Recommends advising patients 60 and older, even with normal vision, on their increased fall risk and need to take extra precautions

Feb. 1, 2010


Fractures that Plague Senior Citizens Can be Reduced by Taking Calcium with Vitamin D

Large study supports growing consensus that combined calcium and vitamin D is more effective than vitamin D alone in reducing fractures

Jan. 14, 2010

Severe, Chronic Pain in Multiple Areas Found to Increase Risk of Falls in Senior Citizens

‘Controlled trial is needed to determine whether improved pain control could reduce risk for falls among older patients with chronic pain’

Nov. 30, 2009

Antidepressants and Sedatives Associated With Risk of Falls for Older Americans

Over 30% of senior citizens (older than 65) will fall at least once a year; falls are the fifth-leading cause of death in the developed world

Nov. 23, 2009

Senate Says First Day of Fall Should Highlight Prevention of Falls for U.S. Senior Citizens

Senate Resolution targets preventing the leading cause of injuries for those 65 and older

Sept. 23, 2009

Senior Citizens Being Urged to Choose and Use Walkers and Canes Carefully

Proper fit and use may prevent some of the 47,000 annual ER visits by elderly who fall

July 14, 2009

Injuries Related to Walking Canes, Walkers are Sending 47,000 Senior Citizens a Year to ERs

Fractures most common injury for these falls; one in three injuries required hospitalization

June 30, 2009

When Seniors Lose Interest in Going Out, the Motor Skills that Took Them Decline Rapidly

One-point decrease on social activity scale was equivalent to being approximately five years older at the start of the study - risk of death, disability jump

June 22, 2009

Inner Ear Balance Disorders Come with Age; Major Cause of Falls by Senior Citizens

Vestibular disorders are most common cause of dizziness in older people, responsible for 50% of dizziness in elderly.

May 26, 2009

Senior Citizens ‘Inoculated’ Against Falling in Successful Research Project

Shows how brain develops fall prevention strategies that can be generalized to variety of conditions

Feb. 4, 2009

Physical and Cognitive Declines Increase with Age Due to Slow Decay of Nerve Insulation

Myelin breakdown is a process of aging underlying the erosion of physical skills and cognitive ability

Oct. 19, 2008

Sen. Mikulski Wins Again in Fight Against Senior Falls: Senate Adopts Awareness Day

National Falls Prevention Awareness Day was approved by Senate for September 22

Sept. 23, 2008

Elderly Women Increase Their Risk of Falling with Less Than Five Hours Sleep

About one-third of adults older than age 65 experience falls each year

Sept. 8, 2008

iShoe by MIT Student May Save Thousands of Senior Citizens from Deadly Falls

Future versions could help correct problems by providing sensory stimulation to the feet when the wearer is off-kilter

August 1, 2008

Senior Citizens Learning to Fall Like a Skydiver Can Reduce Hip Fractures by 70 Percent

Parachutist's landing best reduces hip impact whether you jumped from an airplane or tripped on a curb

July 7, 2008

Nearly 8,000 Senior Citizens Die from Traumatic Brain Injuries Following Falls

TBIs maybe missed or misdiagnosed among older adults but 56,000 hospitalized in 2005

July 2, 2008

Senior Citizens Having Problems with Balance, Walking Can Blame Their Brain

People with severe white matter changes were twice as likely to score poorly on the walking and balance tests

March 17, 2008

Risk of Falling Is Overlooked as the Major Cause of Fractures in the Elderly

Evidence says fall prevention can reduce falls by up to 50%

Jan. 18, 2008

Exercise Does Help Senior Citizens Improve Balance Says Data from 34 Studies

Rising from a chair and standing on one leg is enough to help

Oct. 17, 2007

Senior Citizens Improve Mobility Better With Balance Training than Tai Chi

Both reduce falls, more improvement from balance, stepping and mobility

December 11, 2006

Senior Citizens Gain Health, Independence, Balance with Exercise

Goal of study is prevention - keeping people out of nursing homes - Nov. 22, 2006


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