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Annales de Gérontologie

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

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Authors
Service de gérontologie clinique, CHU d’Angers, Service de gérontologie clinique, CHU de Saint-Étienne, FORMADEP, groupe Korian, Paris

In Europe and United States, about 85% of old subjects of 65 years and over take at least one medication daily, and 48% take 3 or more. Furthermore, one out of three subject from 65 years and 1 out of 2 over 80 years fall. Because of the strong prevalence of these two phenomena beyond the age of 65 years, the coexistence of fall and daily intake of one or many medications is frequent in geriatrics. When the clinician is confronted to this situation, the issue is how to identify the relationship between both fall and medication. Most often, when we consider in the elderly the relation medication-fall, it is important not to limit medication role as that of simple risk factor, because some medications may have an opposite effect; risk fall reduction. This is especially the case of dopatherapy or antiepileptics that reduce or get rid of neurological symptoms responsible for fall. Beside direct or indirect role may has the medicament in fall mechanism, whether as risk factor or protector factor of fall, the relation medication-fall should be also considered for sequels of medication intake in case of falls. The most classic example, and likely the more frequent, is that of a clinician confronted to the question of anticoagulant prescription or continuation in an elder faller or at high fall risk, because of hemorrhagic complications related to traumatic falls.