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Annales de Gérontologie

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Medication and fall in older adults Volume 1, numéro 1, Octobre-Novembre-Décembre 2008

Auteurs
Department of Clinical Gerontology, University Hospital Angers, 49933 Angers cedex 9, Department of Clinical Gerontology, University Hospital Saint Etienne, FORMADEP – Group Korian, Paris

In Europe and United States, about 85% of adults aged 65 years over take at least one medication per day, and 48% take 3 or more. Furthermore, around 35% of them suffer a fall at least once a year. Because of the high prevalence of these two phenomena among older adults, the coexistence of fall and medication daily intake is frequent in geriatrics. The issue while the clinician is confronted to this situation is how to caracterized the relationship between both fall and medication. Most often, when we consider the relation “medication-fall” among older adults, it is important not limiting medication role as that of simple risk factor, because some medications may have an opposite effect like risk fall reduction. This is especially the case of dopatherapy or antiepileptic drugs that reduce or get rid of neurological symptoms leading to fall. Beside direct or indirect role of medication in fall mechanism, whether as risk factor or protector factor of fall, the relation “medication-fall” should also be considered for fall related adverse outcome. The most classic example, and likely the more frequent, is the question of anticoagulant prescription among faller or at high fall risk, because of hemorrhagic complications related to traumatic falls.