Antidepressant Use and Recurrent Falls in Community-Dwelling Older Adults: Findings From the Health ABC Study

Ann Pharmacother. 2016 Jul;50(7):525-33. doi: 10.1177/1060028016644466. Epub 2016 Apr 11.

Abstract

Background: Few studies have compared the risk of recurrent falls across various antidepressant agents-using detailed dosage and duration data-among community-dwelling older adults, including those who have a history of a fall/fracture.

Objective: To examine the association of antidepressant use with recurrent falls, including among those with a history of falls/fractures, in community-dwelling elders.

Methods: This was a longitudinal analysis of 2948 participants with data collected via interview at year 1 from the Health, Aging and Body Composition study and followed through year 7 (1997-2004). Any antidepressant medication use was self-reported at years 1, 2, 3, 5, and 6 and further categorized as (1) selective serotonin reuptake inhibitors (SSRIs), (2) tricyclic antidepressants, and (3) others. Dosage and duration were examined. The outcome was recurrent falls (≥2) in the ensuing 12-month period following each medication data collection.

Results: Using multivariable generalized estimating equations models, we observed a 48% greater likelihood of recurrent falls in antidepressant users compared with nonusers (adjusted odds ratio [AOR] = 1.48; 95% CI = 1.12-1.96). Increased likelihood was also found among those taking SSRIs (AOR = 1.62; 95% CI = 1.15-2.28), with short duration of use (AOR = 1.47; 95% CI = 1.04-2.00), and taking moderate dosages (AOR = 1.59; 95% CI = 1.15-2.18), all compared with no antidepressant use. Stratified analysis revealed an increased likelihood among users with a baseline history of falls/fractures compared with nonusers (AOR = 1.83; 95% CI = 1.28-2.63).

Conclusion: Antidepressant use overall, SSRI use, short duration of use, and moderate dosage were associated with recurrent falls. Those with a history of falls/fractures also had an increased likelihood of recurrent falls.

Keywords: aging; antidepressants; drug-related problems; epidemiology; geriatrics; outcomes research/analysis; pharmacoepidemiology.

Publication types

  • Observational Study

MeSH terms

  • Accidental Falls / statistics & numerical data*
  • Adult
  • Aged
  • Aged, 80 and over
  • Aging* / drug effects
  • Antidepressive Agents / administration & dosage
  • Antidepressive Agents / adverse effects
  • Antidepressive Agents / therapeutic use*
  • Dose-Response Relationship, Drug
  • Drug Utilization
  • Female
  • Fractures, Bone / epidemiology*
  • Humans
  • Longitudinal Studies
  • Male
  • Multivariate Analysis
  • Odds Ratio
  • Recurrence
  • Risk
  • Self Report
  • Serotonin Uptake Inhibitors / administration & dosage
  • Serotonin Uptake Inhibitors / adverse effects
  • Serotonin Uptake Inhibitors / therapeutic use*
  • United States

Substances

  • Antidepressive Agents
  • Serotonin Uptake Inhibitors