“Our study indicates two trends increasing concurrently at a population level that should be examined at the individual level. Our hope is it will start more conversations on health care teams about the pros and cons of medications prescribed for vulnerable populations,” said Amy Shaver, PharmD, lead investigator and postdoctoral associate in the UB School of Public Health and Health Professions.
For their study, the UB researchers analyzed data on deaths caused by falls and on prescription fills among people 65 and older from the National Vital Statistics System and the Medical Expenditure Panel Survey.
Fall-risk-increasing drugs — or FRIDs — include antidepressants, anticonvulsants, antipsychotics, antihypertensives (for high blood pressure), opioids, sedative hypnotics, and benzodiazepines (tranquilizers such as Valium and Xanax), as well as other nonprescription medications.
From 1999-2017, more than 7.8 billion FRID orders were filled by older adults in the United States. The majority of the prescriptions were for high blood pressure medications, but there was a sharp rise in antidepressant prescriptions, from 12 million in 1999 to more than 52 million in 2017.
“The rise in the use of antidepressant medications seen in this study is likely related to the use of these agents as safer alternatives to older medications for conditions such as depression and anxiety,” Shaver said. “However, it is important to note that these medications are still associated with increased risks of falls and fractures among older adults.”
The researchers found women were more likely than men to be prescribed FRIDs, particularly Black women, who received the medications at the highest rate compared to women of other races. White women who were 85 and older experienced the largest increase in deaths from falls, rising 160% between 1999 and 2017.
The study was published January 30 in the journal Pharmacoepidemiology and Drug Safety.