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Potentially serious alcohol-medication interactions and falls in community-dwelling older adults: A prospective cohort study

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posted on 11.06.2021, 11:00 by Alice Holton, Fiona Boland, Paul Gallagher, Tom Fahey, Frank Moriarty, Rose Anne Kenny, Grainne Cousins

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.

Funding

Royal College of Surgeons in Ireland under the Clement Archer PhD Scholarship

History

Comments

The original article is available at https://academic.oup.com

Published Citation

Holton A, Boland F, Gallagher P, Fahey T, Moriarty F, Kenny RA, Cousins G. Potentially serious alcohol-medication interactions and falls in community-dwelling older adults: a prospective cohort study. Age Ageing. 2019;48(6):824-831.

Publication Date

3 October 2019

PubMed ID

31579905

Department/Unit

  • General Practice
  • HRB Centre for Primary Care Research
  • School of Pharmacy and Biomolecular Sciences

Research Area

  • Population Health and Health Services

Publisher

Oxford University Press (OUP)

Version

  • Published Version (Version of Record)