Medication-Related Falls in Older People : Causative Factors and Management Strategies

"Comprising a single repository of knowledge and scientific evidence in the field, this book provides strategies to mitigate fall risk by providing information on the complex interactions between aging processes, co-morbid conditions and prescribed medications in older patients. Geriatric health is becoming a more prominent issue as the population ages, and balancing the beneficial effects of medication against the potential and real side-effects in these patients involves a deliberate and thoughtful task: physiologic aging, the accumulation of co-morbidities, and the use of drugs to manage various conditions and symptoms generates a unique set of problems for each patient. Falls are a dreaded event in older people. The event can affect a person in a physical, and psychological manner, resulting in soft tissue and bony injury, fear of falling, and depression. The identification of and reduction in fall risks in older people is a worldwide concern, and reducing the incidence of falls is a ubiquitous quality measure of health care delivery. Heterogeneity amongst older people precludes a single solution. However, physicians and others involved in the care of geriatric patients will benefit from the presented insights into how medication use can be modified to limit its impact as a contributing factor"--Publisher's description Front Matter....Pages i-viii Front Matter....Pages 1-1 Introduction....Pages 3-5 The Aging Population and Falls: Consequences and Costs....Pages 7-11 Falls Count and Counting Falls: Making Sense of Data About Falls....Pages 13-38 Front Matter....Pages 39-39 Polypharmacy....Pages 41-54 Pharmacology of Drugs in Aging....Pages 55-66 Age-Related Physical and Physiologic Changes and Comorbidities in Older People: Association with Falls....Pages 67-73 Adverse Events and Falls....Pages 75-89 Risk Factors for Falls in the Elderly....Pages 91-101 Front Matter....Pages 103-103 Psychotropic Drugs....Pages 105-124 Benzodiazepines....Pages 125-133 Drugs for Degenerative Neurologic Conditions: Antiparkinson Medications, Cholinesterase Inhibitors, and Memantine....Pages 135-146 Antihypertensives and Cardiovascular Medications....Pages 147-160 Glucose Control Medications....Pages 161-167 Front Matter....Pages 169-169 Inappropriate Medications and Risk of Falls in Older Adults....Pages 171-177 Identifying Explicit Criteria for the Prevention of Falls....Pages 179-189 Approach to Medication Reviews in Older Adults....Pages 191-198 Withdrawal of Fall Risk-Increasing Drugs....Pages 199-211 Benzodiazepine Withdrawal in the Elderly: A Practical Approach....Pages 213-222 Role of Information and Communication Technologies....Pages 223-231 A Novel Personalized Fall Risk Calculator: A Prototype for Improving the Safety of Prescribing Through Computerized Decision Support....Pages 233-252 Front Matter....Pages 169-169 Future Directions....Pages 253-261