To systematically review medication-related risk factors for falls in older adults, to provide references for ensuring medication safety among older adults.
METHODS
2
A systematic search was conducted in PubMed, Embase, Web of Science, and CNKI for relevant literature published from database inception to November 1, 2025. Relevant studies on medication-related falls in older adults, both domestic and international, were included. Drug factors influencing falls in older adults were summarized and analyzed.
RESULTS
2
A total of 22 studies were included. Four major classes of fall-risk-increasing drugs were identified: psychotropic medications [12 studies, odds ratio (OR) range 1.500-5.790], cardiovascular system drugs (5 studies, OR range 1.236-4.784), analgesics (3 studies, OR range 1.500-4.490), and hypoglycemic agents (3 studies, OR range 2.070-2.751). Additionally, anticholinergic burden (1 study, OR was 2.610) and polypharmacy (7 studies, OR range 2.902-25.897 for the use of ≥4 medications) were identified as significant risk factors for falls.
CONCLUSIONS
2
Falls in older adults are significantly associated with psychotropic medications, cardiovascular system drugs, analgesics, and hypoglycemic agents, among which psychotropic medications pose the highest risk. Anticholinergic burden and polypharmacy are also important risk factors. In clinical practice, interventions should be implemented through deprescribing and risk monitoring to effectively reduce the risk of falls in older adults.
关键词
Keywords
references
KUMAR S , CRUZ F , YATES Z , et al . Falls among older adults:an exploration of trends,clinical outcomes,predisposing risk factors,and intervention strategies [J ] . Am J Surg , 2025 , 245 : 116385 .
World Health Organization . Falls [EB/OL ] . ( 2021-04-26 )[ 2025-10-07 ] . https://www.who.int/news-room/fact-sheets/detail/falls https://www.who.int/news-room/fact-sheets/detail/falls .
SEPPALA L J , WERMELINK A M A T , DE VRIES M , et al . Fall-risk-increasing drugs:a systematic review and meta-analysis:Ⅱ. Psychotropics [J ] . J Am Med Dir Assoc , 2018 , 19 ( 4 ): 371.e11 - 371.e17 .
VAN DER VELDE N , STRICKER B H C , POLS H A P , et al . Risk of falls after withdrawal of fall-risk-increasing drugs:a prospective cohort study [J ] . Br J Clin Pharmacol , 2007 , 63 ( 2 ): 232 - 237 .
ARKSEY H , O’MALLEY L . Scoping studies:towards a methodological framework [J ] . Int J Soc Res Methodol , 2005 , 8 ( 1 ): 19 - 32 .
EBRAHIM N , RAS J , NOVEMBER R , et al . Medication use and fall risk among older adults in long-term care facilities:a cross-sectional analysis [J ] . S Afr J Sports Med , 2025 , 37 ( 1 ): v37i1 a 20605 .
NA I , SEO J , PARK E , et al . Risk of falls associated with long-acting benzodiazepines or tricyclic antidepressants use in community-dwelling older adults:a nationwide population-based case-crossover study [J ] . Int J Environ Res Public Health , 2022 , 19 ( 14 ): 8564 .
LIN X Z , MENG R L , PENG D D , et al . Cross-sectional study on prevalence and risk factors for falls among the elderly in communities of Guangdong Province,China [J ] . BMJ Open , 2022 , 12 ( 11 ): e062257 .
LYU H , DONG Y , ZHOU W H , et al . Incidence and clinical characteristics of fall-related injuries among older inpatients at a tertiary grade a hospital in Shandong Province from 2018 to 2020 [J ] . BMC Geriatr , 2022 , 22 ( 1 ): 632 .
MACHADO-DUQUE M E , CASTAÑO-MONTOYA J P , MEDINA-MORALES D A , et al . Association between the use of benzodiazepines and opioids with the risk of falls and hip fractures in older adults [J ] . Int Psychogeriatr , 2018 , 30 ( 7 ): 941 - 946 .
GARCÍA B P , GONZÁLEZ S M , MUÑOZ A M C , et al . Risk of drug-related falls among noninstitutionalized older adults [J ] . Rev Esc Enferm USP , 2018 , 52 : e03319 .
WEDMANN F , HIMMEL W , NAU R . Medication and medical diagnosis as risk factors for falls in older hospi- talized patients [J ] . Eur J Clin Pharmacol , 2019 , 75 ( 8 ): 1117 - 1124 .
AKANDE-SHOLABI W , OGUNDIPE F S , ADEBUSOYE L A . Medications and the risk of falls among older people in a geriatric centre in Nigeria:a cross-sectional study [J ] . Int J Clin Pharm , 2021 , 43 ( 1 ): 236 - 245 .
MACHADO-DUQUE M E , CAMACHO-ARTEAGA L , SABATÉ M , et al . Falls in hospitalized older adults and the use of fall risk-increasing drugs and anticholinergic medications in Colombia:a case-control study [J ] . Front Pharmacol , 2024 , 15 : 1369200 .
ÉRSZEGI A , CSUPOR D , BODÓ G , et al . High rate of potentially inappropriate medication use in older people:a case-control study [J ] . Geroscience , 2024 , 46 ( 5 ): 5217 - 5233 .
TORII H , ANDO M , TOMITA H , et al . Association of hypnotic drug use with fall incidents in hospitalized elderly patients:a case-crossover study [J ] . Biol Pharm Bull , 2020 , 43 ( 6 ): 925 - 931 .
HAINES K L , FULLER M , VAUGHAN J G , et al . The impact of nonsteroidal anti-inflammatory drugs on older adult trauma patients with hip fractures [J ] . J Surg Res , 2020 , 255 : 583 - 593 .
HART L A , PHELAN E A , YI J Y , et al . Use of fall risk-increasing drugs around a fall-related injury in older adults:a systematic review [J ] . J Am Geriatr Soc , 2020 , 68 ( 6 ): 1334 - 1343 .
Analysis of the disease burden of falls and influencing factors among the elderly from 1990 to 2023
Bibliometric Analysis of Research Status and Hotspot Frontier of Polypharmacy in the Elderly
Study on the influencing factors of venetoclax trough concentration and its association with efficacy in patients with acute myeloid leukemia
Effects of ω-3 polyunsaturated fatty acid combined with clomiphene on clinical efficacy, pregnancy and safety in patients with polycystic ovary syndrome
Mechanism of Qingre antai decoction in improving pregnancy outcomes of threatened abortion rats with blood heat syndrome based on JAK2/STAT3 and PI3K/AKT dual signaling pathways