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

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 wit...

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Bibliographic Details
Published in:The Annals of pharmacotherapy 2016-07, Vol.50 (7), p.525-533
Main Authors: Marcum, Zachary A., Perera, Subashan, Thorpe, Joshua M., Switzer, Galen E., Castle, Nicholas G., Strotmeyer, Elsa S., Simonsick, Eleanor M., Ayonayon, Hilsa N., Phillips, Caroline L., Rubin, Susan, Zucker-Levin, Audrey R., Bauer, Douglas C., Shorr, Ronald I., Kang, Yihuang, Gray, Shelly L., Hanlon, Joseph T.
Format: Article
Language:English
Subjects:
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
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Summary: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.
ISSN:1060-0280
1542-6270
DOI:10.1177/1060028016644466