Adverse drug reactions in the elderly as a contributing factor for hospital admission

An article in the British Medical Journal, Vol. 315, Oct. 25 1997, reviewed adverse drug events (ADEs) as contributing factors for hospital admission in older adults. Two things are of interest in this article: 1) They calculated an Odds Ratio (OR), which is the statistical correlation between events or variables, of 51.3 between severe ADEs and falls. (An example of a severe ADE is gastrointestinal bleeding or internal hemorrhage) The higher the OR the stronger the correlation. Putting that into perspective, leg weakness has an OR of 4.4 when correlated with falls, cognitive impairment has an OR of 1.8, gait deficits 2.9, balance deficits 2.9 and over age of 80 carrying an OR of 1.7. That means that severe ADEs are closely tied to falls and identifying medications as risk factors for falls can lead to intervention and prevention of falls. 2) They asked if people had complaints caused by their drugs. A correct opinion was found in 79% of respondents who answered “yes”, meaning a non-severe ADE was confirmed when people thought a medication was causing a problem 79% of the time. This means that people are fairly astute at recognizing non-severe ADEs from any of their medications. However, 72% were not able to sense they were experiencing a severe ADE such as gastrointestinal bleeding.

When you suspect a medication may be causing a problem, don’t let it go but persist in finding out what’s going on. There is a strong likelihood that you are experiencing an ADE that can impact your function and quality of life. When looking at falls and ADEs, there are a number of strategies that can be employed to help reduce your risk of a fall, one being reducing medication use altogether, lowering doses of blood pressure medications when you experience dizziness, staying away from drugs that are strongly associated with falls such as benzodiazepines, which are drugs like Valium (diazepam), Ativan (lorazepam), Xanax (alprazolam), and other drugs even as apparently innocuous such as Tylenol PM (acetaminophen & diphenhydramine) and Benadryl (diphenhydramine). Even these over-the-counter (OTC) medications are known to contribute to falls. There is more to know about the relationship between falls and medications and this is only an introduction to set you in the right direction. Keep in mind that any changes in your medication regimen should be done only under the supervision of an experienced medical professional who is well versed in this area. That’s it for now, stay well and stay upright!