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Fall-risk-increasing drugs and falls requiring health care among older people with intellectual disability in comparison with the general population : A register study

Axmon, Anna LU ; Sandberg, Magnus LU ; Ahlström, Gerd LU and Midlöv, Patrik LU (2018) In PLoS ONE 13(6). p.1-11
Abstract

BACKGROUND: Falls are the most common cause of injury for older people in the general population as well as among those with intellectual disability. There are many risk factors for falls, including a range of drugs which are considered to be fall-risk-increasing (FRIDs). The aim of the present study was to describe prescription patterns of FRIDs in itself as well as in relation to falls requiring health care among older people with intellectual disability and their age-peers in the general population. Moreover, to investigate possible differences between the two groups.

METHODS: A cohort of people with intellectual disability and a referent cohort, one-to-one-matched by sex and year of birth, were established. Each cohort... (More)

BACKGROUND: Falls are the most common cause of injury for older people in the general population as well as among those with intellectual disability. There are many risk factors for falls, including a range of drugs which are considered to be fall-risk-increasing (FRIDs). The aim of the present study was to describe prescription patterns of FRIDs in itself as well as in relation to falls requiring health care among older people with intellectual disability and their age-peers in the general population. Moreover, to investigate possible differences between the two groups.

METHODS: A cohort of people with intellectual disability and a referent cohort, one-to-one-matched by sex and year of birth, were established. Each cohort comprised 7936 people aged 55+ years at the end of 2012. Register data were collected for 2006-2012 on prescription of antidepressants, anxiolytics, hypnotics and sedatives, opioids, and antipsychotics, as well as for fall-related health care contacts. Analyses were performed on yearly data, using repeated measures models.

RESULTS: People with intellectual disability were more likely to be prescribed at least one FRID (Relative Risk [RR] 2.31). The increase was highest for antipsychotics (RR 25.0), followed by anxiolytics (RR 4.18), antidepressants (RR 2.72), and hypnotics and sedatives (RR 1.42). For opioids, however, a lower prevalence (RR 0.74) was found. In both cohorts, those with prescription of at least one FRID were more likely to have a fall-related injury that required health care. The increased risk was higher in the referent cohort (RR 3.98) than among people with intellectual disability (RR 2.27), although people with intellectual disability and prescription still had a higher risk of falls than those with prescription in the referent cohort (RR 1.27). A similar pattern was found for all drug groups, except for opioids, where prescription carried the same risk of having a fall-related injury that required health care in both cohorts.

CONCLUSIONS: With or without prescription of FRIDs, older people with ID have a higher risk of falls requiring health care than their age-peers in the general population. It is important to be aware of this when prescribing drugs that further increase the risk of falls.

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author
organization
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type
Contribution to journal
publication status
published
subject
in
PLoS ONE
volume
13
issue
6
pages
1 - 11
publisher
Public Library of Science
external identifiers
  • scopus:85048741547
ISSN
1932-6203
DOI
10.1371/journal.pone.0199218
language
English
LU publication?
yes
id
33d5f2be-dfb3-4166-a781-4c91d005f4ca
date added to LUP
2018-06-25 14:46:20
date last changed
2018-07-08 04:32:19
@article{33d5f2be-dfb3-4166-a781-4c91d005f4ca,
  abstract     = {<p>BACKGROUND: Falls are the most common cause of injury for older people in the general population as well as among those with intellectual disability. There are many risk factors for falls, including a range of drugs which are considered to be fall-risk-increasing (FRIDs). The aim of the present study was to describe prescription patterns of FRIDs in itself as well as in relation to falls requiring health care among older people with intellectual disability and their age-peers in the general population. Moreover, to investigate possible differences between the two groups.</p><p>METHODS: A cohort of people with intellectual disability and a referent cohort, one-to-one-matched by sex and year of birth, were established. Each cohort comprised 7936 people aged 55+ years at the end of 2012. Register data were collected for 2006-2012 on prescription of antidepressants, anxiolytics, hypnotics and sedatives, opioids, and antipsychotics, as well as for fall-related health care contacts. Analyses were performed on yearly data, using repeated measures models.</p><p>RESULTS: People with intellectual disability were more likely to be prescribed at least one FRID (Relative Risk [RR] 2.31). The increase was highest for antipsychotics (RR 25.0), followed by anxiolytics (RR 4.18), antidepressants (RR 2.72), and hypnotics and sedatives (RR 1.42). For opioids, however, a lower prevalence (RR 0.74) was found. In both cohorts, those with prescription of at least one FRID were more likely to have a fall-related injury that required health care. The increased risk was higher in the referent cohort (RR 3.98) than among people with intellectual disability (RR 2.27), although people with intellectual disability and prescription still had a higher risk of falls than those with prescription in the referent cohort (RR 1.27). A similar pattern was found for all drug groups, except for opioids, where prescription carried the same risk of having a fall-related injury that required health care in both cohorts.</p><p>CONCLUSIONS: With or without prescription of FRIDs, older people with ID have a higher risk of falls requiring health care than their age-peers in the general population. It is important to be aware of this when prescribing drugs that further increase the risk of falls.</p>},
  articleno    = {e0199218},
  author       = {Axmon, Anna and Sandberg, Magnus and Ahlström, Gerd and Midlöv, Patrik},
  issn         = {1932-6203},
  language     = {eng},
  number       = {6},
  pages        = {1--11},
  publisher    = {Public Library of Science},
  series       = {PLoS ONE},
  title        = {Fall-risk-increasing drugs and falls requiring health care among older people with intellectual disability in comparison with the general population : A register study},
  url          = {http://dx.doi.org/10.1371/journal.pone.0199218},
  volume       = {13},
  year         = {2018},
}