Statins and Hospitalizations from Recurrent Falls in the Elderly

Abstract

Introduction: Statin-induced myopathy might increase the risk of falls in the elderly and change treatment decisions.

Methods: In the following retrospective study, we selected 463 internal medicine patients aged ≥70 years old hospitalized after a fall during 2020-2021. We compared those with and without an admission for a previous fall in the last 12 months. The primary predictors were polypharmacy (≥5 drugs or ≥9 drugs), antidiabetic drugs, psychiatric drugs, drugs for hypertension, and statins (types and dose). Secondary predictors included age, female gender, admission serum creatinine, albumin, and hemoglobin concentrations, smoking at present, the Norton scale, and if the statin was given for primary prevention (no cardiovascular diseases), the patient's ambulatory status, where and when the patient fell, and what the patient was doing when the fall took place. We calculated the odds ratios and 95% confidence intervals for associations with recurrent versus single falls.

Results: There were 463 patients hospitalized after a fall. Their age was 84 ± 7 years, and 47.7% (221/463) were female. There were 19.0% (88/463) who had recurrent falls, 116 patients treated with atorvastatin (25.1%) and 98 treated with other statins (21.2%). The secondary variables were not significantly different in those with and without recurrent falls. There was a significant increase in odds for recurrent falls in those treated with atorvastatin (1.68, 1.01-2.81) and insulin (2.46, 1.23-4.95). Individually, the drugs were not associated with recurrent falls, but the combination of both drugs was associated with a 5.2 (2.1-13.2) increased odds of a recurrent fall.

Conclusions: The finding that the combined treatment with atorvastatin and insulin is associated with recurrent falls in elderly hospitalized patients is novel and warrants further research.

Keywords: Elderly; Recurrent falls; Statins.