Medications That Increase Fall Risk in Older Adults

Posted on by Emily Kil

The leading cause of fatal and nonfatal injuries among seniors in the United States is falling, according to the U.S. Centers for Disease Control and Prevention. The CDC advises that one in four Americans over the age of 65 falls every year. Therefore, preventing falls is a crucial priority for seniors themselves, healthcare providers, family members, and other caregivers.

Often, fall prevention efforts focus on minimizing environmental hazards and improving a senior’s mobility. In regard to fall prevention strategies, minimizing hazards and enhancing mobility is only part of the equation. Attention must be paid to the impact of over-the-counter medications on seniors’ fall risk.

According to researchers from Karolinska Institutet Medical University in Stockholm, Sweden, of the 20 medications most often taken by seniors, over 50 percent increase the risk of falling and associated injury among people over the age of 65. The study concluded that what it describes as “responsible medication management” is a simple way of lowering the risk of seniors falling and sustaining injuries, including fatal injuries.

Prescription Medications, Over-the-Counter Drugs, and Supplements That Increase Risk of Falls

Medications that affect a person’s central nervous system have topped the list of pharmaceuticals that increase fall risk among seniors. These include antidepressants, hypnotics, and opioids. In addition, diuretics, constipation medications, and non-steroidal anti-inflammatory drugs or NSAIDs have become noteworthy for their potential to make individuals unsteady on their feet and more susceptible to falling and sustaining injury.

The Swedish research study referenced a moment ago tracked the medical records of more than 64,000 individuals who were hospitalized as the result of a fall. Researchers uncovered previously unexpected links between fall injuries, medications, and even commonly used dietary supplements.

The study found that the following types of prescription drugs, over-the-counter medications, and dietary supplements have the potential to increase a senior’s fall risk and sustaining what might be severe or even fatal injuries:

  • Antithrombotic agents (antiplatelet and anticoagulant drugs used to prevent blood clots)
  • Drugs used to treat peptic ulcers and gastroesophageal reflux disease (GERD)
  • High-ceiling diuretics (like furosemide)
  • NSAIDs
  • Vitamin B12 and folic acid supplements
  • Constipation drugs
  • Calcium supplements
  • Hypnotics and sedatives
  • Analgesics and antipyretics
  • Opioids
  • Antidepressants
  • Thyroid hormones

Of course, any medication that causes side effects like drowsiness, dizziness, vision problems, gait disturbance, hypotension, increased bleeding risk, or worsening osteoporosis can potentially increase a senior’s chance of falling and sustaining injury.

Physical Consequences of a Fall in the Life of a Senior

The consequences of a senior falling can be significant. As a result, these consequences demand a recounting in this article to stress the importance of understanding the risk associated with certain medications in regard to falling. There are physical consequences of a fall, injuries that a senior is at a considerable risk of sustaining:

  • Fractures: Older individuals tend to have weaker bones. A fall can result in a partial or complete break in bones. The most common types of fall-related fractures are at the hip, forearm, or back.
  • Immobility: After an accident, an individual might have trouble moving. Immobility might last for an extended period of time. Prolonged immobility can result in other health issues that include pressure sores, bone loss, and muscle wasting.
  • Pain or discomfort moving: A fall can lead to a sprain in the back, neck, or limbs. The pain might affect the victim’s ability to move independently for long periods.
  • Unsteady walking: Hip or ankle injuries can make walking a tedious task. Individuals might hobble as they cope with the unhealed limb.


Psychological Effects of Falling

In addition to the physical injuries that can occur when a senior falls, there are psychological effects as well. These include:

  • Frustration and anger: A fall can turn a previously independent senior adult into someone who cannot do anything on their own. This understandably can result in feelings of frustration and anger. These emotions can impact a senior’s attitude and personality.
  • Fear: A fall can cause a senior to experience a heightened sense of fear. For example, a fall down a flight of stairs is a truly traumatic experience. It can result in a senior having a fear (even intense fear) of going up and down the stairs. Fear derived from a fall can result in a senior avoiding certain locations as well as different types of activities.
  • Low self-esteem: The inability to care for oneself can lead to a loss of confidence and esteem. The lack of confidence can create feelings of inadequacy. Low self-esteem can lead to depression and other emotional responses that directly and significantly negatively impact an older person’s life.
  • Inconvenience: The use of walking aids is a common solution after a senior sustains injuries in a fall. Using walking aids can be embarrassing, troubling, and a major inconvenience for a senior. These feelings about the use of walking aids can and oftentimes do have a negative emotional and psychological impact on a senior.


Intangible Consequences of Falling

Finally, there are what fairly can be described as intangible consequences of falling. Some examples of these intangible consequences of falling for a senior include:

  • Loss of independence: An injured senior might end up in need of around-the-clock assistance from family, friends, professional caregivers, or homecare aid. Indeed, the results of a fall might be so consequential that a senior needs to move into an assisted living community or some other suitable type of long-term care facility.
  • Inability to exercise: Exercise improves an older person’s health and wellness. Unfortunately, activities might be impossible after a fall that results in physical injuries. The inability to exercise can have far-reaching consequences when it comes to an older individual’s overall health and wellness.
  • Financial burden: A fall can require surgery, extensive hospitalization, rehabilitation, and in-home care and assistance as a person recovers. Even with Medicare and a supplemental insurance policy, the costs involved with medical attention can create financial obligations for the retired senior. Financial obligations can translate into a significant financial burden in a short period of time.
  • Decreased quality of life: A fall might damage an older person’s overall quality of life. Following a fall or after sustaining injuries from a fall, a senior might be precluded from engaging in activities he or she once enjoyed. A person can become remove them from his or her usual routines and life patterns. Social connections can be damaged as well.


The significant consequences associated with a senior experiencing a fall simply cannot be understated. Therefore, when a medication is prescribed or recommended, attention must be paid to its potential to increase the fall risk. Attempts should be made to see if an alternative exists that doesn’t increase the risk of falling.