Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: I. Cardiovascular Drugs
| Autor: | Tischa J. M. van der Cammen, Irene O'Byrne-Maguire, Joost G. Daams, Max de Vries, Olle Svensson, Maria Angeles Caballero-Mora, Katarzyna Szczerbińska, Hubert Blain, Patrik Eklund, Sirpa Hartikainen, Gösta Bucht, Mirko Petrovic, Francesco Landi, Lotta J. Seppala, Lotta Seppälä, Tahir Masud, Heinrich W. Thaler, Rose Anne Kenny, Lucie Laflamme, Yngve Gustafson, Leocadio Rodriguez, Esther M.M. van de Glind, Marielle H. Emmelot-Vonk, Nathalie van der Velde, Jean Bousquet |
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| Přispěvatelé: | APH - Aging & Later Life, Other departments, Geriatrics, AMS - Amsterdam Movement Sciences, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism |
| Rok vydání: | 2018 |
| Předmět: |
Male
Drug medicine.medical_specialty media_common.quotation_subject Population Nursing(all) MEDLINE PsycINFO Risk Assessment statins 03 medical and health sciences Sex Factors 0302 clinical medicine Internal medicine Prevalence Humans Medicine 030212 general & internal medicine Risk factor education General Nursing Netherlands Aged media_common Aged 80 and over education.field_of_study business.industry Health Policy Age Factors Cardiovascular Agents digoxin General Medicine Odds ratio Middle Aged United Kingdom diuretics Confidence interval cardiovascular medication Meta-analysis Female accidental falls Geriatrics and Gerontology business 030217 neurology & neurosurgery |
| Zdroj: | Journal of the American Medical Directors Association, 19(4), 371.e1. Elsevier Inc. Journal of the American Medical Directors Association, 19(4), 371.e1-371.e9. Elsevier Inc. |
| ISSN: | 1525-8610 |
| DOI: | 10.1016/j.jamda.2017.12.013 |
| Popis: | Background and objective Use of certain medications is recognized as a major and modifiable risk factor for falls. Although the literature on psychotropic drugs is compelling, the literature on cardiovascular drugs as potential fall-risk-increasing drugs is conflicting. The aim of this systematic review and meta-analysis is to provide a comprehensive overview of the associations between cardiovascular medications and fall risk in older adults. Methods Design: A systematic review and meta-analysis. Data sources: Medline, Embase, and PsycINFO. Key search concepts were “fall,” “aged,” “causality,” and “medication.” Studies that investigated cardiovascular medications as risk factors for falls in participants ≥60 years old or participants with a mean age of 70 or older were included. A meta-analysis was performed using the generic inverse variance method, pooling unadjusted and adjusted odds ratios (ORs) separately. Results In total, 131 studies were included in the qualitative synthesis. Meta-analysis using adjusted ORs showed significant results (pooled OR [95% confidence interval]) for loop diuretics, OR 1.36 (1.17, 1.57), and beta-blocking agents, OR 0.88 (0.80, 0.97). Meta-analysis using unadjusted ORs showed significant results for digitalis, OR 1.60 (1.08, 2.36); digoxin, OR 2.06 (1.56, 2.74); and statins, OR 0.80 (0.65, 0.98). Most of the meta-analyses resulted in substantial heterogeneity that mostly did not disappear after stratification for population and setting. In a descriptive synthesis, consistent associations were not observed. Conclusion Loop diuretics were significantly associated with increased fall risk, whereas beta-blockers were significantly associated with decreased fall risk. Digitalis and digoxin may increase the risk of falling, and statins may reduce it. For the majority of cardiovascular medication groups, outcomes were inconsistent. Furthermore, recent studies indicate that specific drug properties, such as selectivity of beta-blockers, may affect fall risk, and drug-disease interaction also may play a role. Thus, studies addressing these issues are warranted to obtain a better understanding of drug-related falls. |
| Databáze: | OpenAIRE |
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