Home > Potentially serious alcohol–medication interactions and falls in community-dwelling older adults: a prospective cohort study.

Holton, Alice and Boland, Fiona and Gallagher, Paul and Fahey, Tom and Moriarty, Frank and Kenny, Rose Anne and Cousins, Grainne (2019) Potentially serious alcohol–medication interactions and falls in community-dwelling older adults: a prospective cohort study. Age and Ageing , Early online .

URL: https://academic.oup.com/ageing/article/doi/10.109...


Objective

To investigate the association between potentially serious alcohol–medication interactions (POSAMINO criteria), hypothesised to increase the risk of falls in older adults, and falls in community-dwelling older adults at two and 4 years follow-up.

Design

A prospective cohort study.

Setting

The Irish Longitudinal Study on Ageing.

Subjects

A total of 1,457 community-dwelling older adults aged ≥65 years, with a complete alcohol and regular medication data to allow for the application of the POSAMINO criteria.

Outcomes

Self-reported falls at 2 and 4 years follow-up, any falls (yes/no), injurious falls (yes/no) and number of falls (count variable).

Results

The number of participants who reported falling since their baseline interview at 2 and 4 years were 357 (24%) and 608 (41.8%), respectively; 145 (10%) reported an injurious fall at 2 years and 268 (18%) at 4 years. Median (IQR) number of falls was 1 (1–2) at 2 years and 2 (1–3) at 4 years. Exposure to CNS POSAMINO criteria, hypothesised to increase the risk of falls due primarily to increased sedation, was associated with a significantly increased risk for falling (adjusted relative risk (RR) 1.50, 95% confidence interval (CI) 1.21–1.88) and for injurious falls (adjusted RR 1.62, 95% CI: 1.03–2.55) at 4 years. These equate to an absolute risk of 19% for falling (95% CI: 5–33%) and 8% for injurious falls (95% CI, 4–20%) at 4 years.

Conclusions

Assessment and management strategies to prevent falls in community-dwelling older adults should consider patients’ alcohol consumption alongside their assessment of patient medications, particularly among those receiving CNS agents.

Item Type:Article
Date:October 2019
Publisher:Oxford University Press
Volume:Early online
EndNote:View
Accession Number:HRB (Electronic Only)
Subjects:B Substances > Alcohol
E Concepts in biomedical areas > Substance by legal status > Prescription drug (medicine / medication)
G Health and disease > Substance use disorder > Alcohol use
J Health care, prevention and rehabilitation > Risk and protective factors > Risk factors
T Demographic characteristics > Elderly / Older person
VA Geographic area > Europe > Ireland

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