Your Medication May Be Putting You At Higher Risk Of Falls

Every second of every day, an older adult falls. Many of these falls cause injuries, loss of independence, and in some cases, death. There are many ways that falls can be prevented.

According to the National Council on Aging, falls are the leading cause of injuries for people 65 and older. What are the reasons for these falls for people in this age group?

According to Johanna Dix, an occupational therapist with Franciscan Health Acute Rehabilitation Indianapolis, different factors can increase the risk of falling.

“As we age, we may lose muscle tone, which may affect balance. Also, changes in our eyesight may make us less sure of our balance,” Dix said.

Medications, both prescribed and over-the-counter, also can increase your risk of falling.

How Medications Affect Your Balance

According to Heather DeYoung, PharmD, BCACP, a pharmacist at Franciscan ACO, older adults can respond to medication, as a whole, more strongly than younger people. This can include a stronger effect on their balance.

“This can be due to changes in kidney function, which may impact how quickly a medication is cleared from the body,” DeYoung said,

Changes in body composition, metabolism and gastrointestinal absorption also can impact how a person’s body reacts to a medication.

“It is also more common to see individuals over 65 taking 10 or more medications. Certain medications or combinations may increase risk of falls or cognitive impairment,” said DeYoung.  “Periodic medication review and monitoring are important. More medications and changes to how the body processes and responds to medications over time may necessitate dose adjustment, consideration of alternatives, or stopping some medications to ensure that benefits continue to outweigh risks.”

What Drugs Increase Risk Of Falling?

It’s extremely common for older adults to be taking medications that have been associated with increased fall risk. There are three categories that these medications fall into.

#1: Medications That Affect The Brain 

Health professionals often refer to drugs that impact the brain as “psychoactives.” Psychoactive medications affect brain function. Many tend to cause some sedation or drowsiness. They also can cause or worsen confusion, especially in people with memory problems or Alzheimer’s disease.

Some psychoactive medications include:

• Anticonvulsants
• Antidepressants
• Antipsychotics
• Benzodiazepines
• Opioids
• Sedatives-hypnotic

#2: Medications That Affect Blood Pressure

These are drugs that can cause or worsen a sudden fall in blood pressure. A drop in blood pressure, or chronically low BP, can increase fall risk.

Older adults can easily experience a quick drop in blood pressure when they stand or sit up. When blood pressure drops, less blood can go to organs and muscles, increasing risk of falling. This is called postural (or orthostatic) hypotension- morning.

Most medications for high blood pressure can cause or worsen postural hypotension.

Symptoms of hypotension can include:

• Dizziness or lightheadedness
• Feeling about to faint
• Passing out or falling
• Headaches
• Blurry or tunnel vision
• Feeling vague or muddled
• Feeling pressure across the back of your shoulders or neck
• Feeling nauseous, or hot and clammy
• Weakness or fatigue

#3: Medications That Lower Blood Sugar

People with diabetes have a higher risk of falls compared to others of the same age. Hypoglycemia (low blood sugar) due to medications or other factors is associated with falls in people with diabetes.

Taking Medications That Make You Tired Or Dizzy?

“If you are taking medications and you find that you’re dizzy or sleepy during the day, talk to your doctor as soon as possible,” said Patrick Laboe, MD, an independent orthopedic surgeon who chooses to practice at Franciscan Health. “He or she can review your prescriptions, as well as over-the-counter medications and supplements, and help you identify the issues and make suggestions.”

Particularly if you are over 65 years old, reviewing medications, over-the-counter medications and herbal supplements with a healthcare provider is important.

Taking the time to review what medications and supplements you are taking can help you reduce interactions and side effects that may lead to falls. Your provider may change or stop medications or medication doses to help you better manage your symptoms, health conditions and risk of falling.

More Ways To Reduce Risk Of Falling

As you age, your risk of falling becomes greater. This is because of changes in vision and balance, along with other medical and physical conditions. Most people also lose bone density as they age, so the risk of broken bones from falls is a greater concern. Older adults can take steps to lower the risk of falling. Here are ideas:

• Limit the amount of alcohol you drink.
• Have your vision and hearing checked regularly.
• Wear rubber-soled and low-heeled shoes that fit properly and support your feet. Don't wear loose-fitting slippers that could cause you to trip.
• Be careful on wet or icy sidewalks.
• Exercise regularly to stay flexible and keep your bones strong.