7 Types of Drugs Likely to Increase Fall Risk for Older People

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Health Viewpoints

When President Joe Biden walked off the stage at the Springs Air Force Academy graduation ceremony in June 2023, he fell to the ground. This is not the first time he has fallen in public.

Slipping and falling is a common yet dangerous phenomenon among the older population. More than a quarter of older Americans fall each year, and 1 in 5 of these falls results in a severe injury, such as a broken bone or head injury. Additionally, each year, 3 million older people need to call for emergency treatment after suffering falls with injuries.

Older people must master how to avoid slipping and falling, and this article can help.

Dangerous Consequences of Falls in Older Adults

Older people are often prone to fractures, usually in the wrist, ankle, and hip, due to falls because many have osteoporosis. Of the more than 300,000 older adults hospitalized with hip fractures each year, more than 95 percent of hip fractures are caused by falls, often sideways falls.

When older people fall, they are often unable to adjust their body balance in time, so these falls can result in head injury. One of my patients had no symptoms after falling, but after a few days, his consciousness became increasingly unclear, and he was finally sent to the hospital, where he was found to have a hemorrhage outside the dura mater.

Therefore, if you fall and hit your head, do not brush it off, even if there are no immediate symptoms. Stay vigilant. If headaches, unconsciousness, or lethargy appear, it is best to go to the hospital to check for epidural hemorrhage.

Another risk for older people is being bedridden after a fall. This can lead to health complications, such as lung infection, blood clots, and bed sores, which can even lead to death in severe cases.

Slipping and falling can also be traumatic for older people, resulting in psychological distress and anxiety. If this happens, they may reduce physical activity and avoid social interaction due to fear of another fall, thus resulting in impacted mental well-being.

4 Factors That Contribute to Falls Among Older People

Older people have multiple risk factors that can make them more prone to falling, including the following:

1. Poor balance: Degeneration of the bones and muscles accompanies aging, reducing agility. Older people often have shorter strides, stuttered pace, stiff limbs, an inability to lift their feet to an appropriate height, and so on. These will cause an unsteady gait and increase the risk of falling. Central nervous system degeneration in older adults can also lead to delayed reaction time. In severe cases, neurodegenerative diseases such as Parkinson’s will also increase the risk of falls.
2. Blurry vision: Many older people suffer from various eye conditions such as presbyopia, glaucoma, cataracts, retinopathy, and macular degeneration. Some also have autoimmune diseases, such as multiple sclerosis, which may cause vision loss. In these situations, it is easy to miss things underfoot.
3. Cardiovascular and cerebrovascular diseases: Patients with chronic cardiovascular and cerebrovascular diseases may experience uncoordinated movements, partial vision, and weakened muscle strength. The most dangerous thing is falls following the abrupt onset of disease. One of my classmates happened to be standing on a ladder repairing the house when a sudden heart attack struck him. The two issues combined led to his death.
4. Medication: Some older people are taking prescription medication. These drugs may affect muscle strength, mental state, balance, blood pressure, or vision, increasing the risk of falling.

Among these four risk factors, the influence of drugs is the worthiest of attention. When I was a resident physician in the United States, one of my mentors told me, “If a person has a new symptom, the first thing you should think of is the side effect of the drug.” This statement has made a deep impression on me for many years because, according to my own clinical experience, it is quite true.

7 Types of Drugs That May Increase Fall Risk

Older adults should talk to their doctors about whether their medication might increase their risk of falls. The following seven drugs may increase fall risk:

1. Sedatives and hypnotics: These drugs can make you feel drowsy at night and affect your ability to concentrate and react during the day.
2. Anxiolytics: This type of hypnotic can make you feel drowsy during the day or simply slow your response time.
3. Antidepressants: Some antidepressants cause blood pressure to rise or fall. When one changes posture from sitting to standing, orthostatic hypotension will increase the chance of falls.
4. Antipsychotics: These affect coordination, causing muscle stiffness and an unsteady gait.
5. Heart disease drugs: Medicines to lower blood pressure and treat arrhythmias can cause dizziness and balance problems.
6. Analgesics: Some pain relievers, especially the opioid type, can make people more prone to drowsiness and cause balance problems.
7. Diuretics: Frequent urination can lead to dehydration, leading to a drop in blood pressure, thus increasing the risk of falling.

7 Tips for Preventing Falls

Falls are largely preventable. In addition to being careful while taking prescription drugs, older people should also implement the following behaviors in daily life:

• Perform muscle-strengthening and balance training: A systematic analysis study published in the Cochrane Database of Systematic Reviews in 2018 showed that exercise can reduce the risk of falling in older people. Traditional Chinese qigong tai chi is an effective form of exercise. In Oregon, 670 older adults who had fallen or had limited mobility in the previous year participated in a randomized controlled trial, according to a 2018 study published in JAMA Internal Medicine. Participants were all aged 70 or above and randomly assigned to three groups: tai chi, stretching, and various exercises. They performed their respective exercises for 24 weeks, twice weekly, 60 minutes each time. The results showed that the tai chi group had 58 percent fewer falls than the stretching group and 31 percent fewer falls than the various exercises group.
• Create a safe home environment: For example, the room should be brightly lit, with anti-collision strips on the corners of the furniture. Do not use furniture with wheels at the bottom; put nonslip mats in the bathroom, and install handrails on the bathroom wall next to the toilet.
• Wear the right type of shoes: High heels, slip-on shoes, and ill-fitting shoes increase the risk of falls.
• Maintain eye and ear health: Ensuring your senses are functioning properly can help you avoid falls.
• Supplement calcium and vitamin D: Calcium does more than just build strong bones. It helps our muscles, heart, and nerves work properly, while vitamin D helps us absorb the calcium we obtain from food.
• Limit alcohol: After consuming alcoholic drinks, judgment on distance and body coordination will be impaired, increasing the risk of falling.
• Get regular health checkups: Many older people with chronic diseases do not fully understand all their underlying health problems, so they cannot control them in time, which may also increase the risk of falling.

Views expressed in this article are the opinions of the author and do not necessarily reflect the views of The Epoch Times. Epoch Health welcomes professional discussion and friendly debate. To submit an opinion piece, please follow these guidelines and submit through our form here.