Fall-risk-increasing drug use in older community-dwelling adults: prevalence, association with fall-related admissions and post-discharge prescribing changes-a retrospective cohort study.
5 affiliations
- 1Department of General Practice, School of Medicine, University College Cork, Cork, Ireland.
- 2School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
- 3Department of Public Health and Epidemiology, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
- 4Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
- 5Department of Medicine, School of Medicine, University College Cork, Cork, Ireland.
Abstract
Background
Fall-risk-increasing drugs (FRIDs) may contribute to a higher falls-risk in older people, but research examining standardised screening tools is limited.Objectives
To examine FRID prevalence in community-dwelling older adults, any association with subsequent fall-related hospital admissions, and FRID prescriptions before and after admission.Design
Retrospective cohort study.Subjects/setting
Adults aged ≥65 years across 44 general practices in Ireland.Methods
Fourteen FRIDs, defined by Screening Tool of Older Persons Prescriptions in older adults with high Fall risk (STOPPFall) criteria, were examined as time-varying exposures from 2012 to 2016. The association between FRID exposure and fall-related admissions was estimated using Cox proportional hazards models, adjusted for relevant confounders. Participants' FRID use pre- and post-fall-related admission was analysed descriptively.Findings
Of the 35 942 participants, 16 780 (47%) were prescribed at least one long-term FRID at baseline, and 867 (2.4%) experienced a subsequent fall-related admission. Long-term FRID use was associated with a higher risk of fall-related admission [adjusted hazard ratio (aHR) 2.85, 95% CI 2.13-3.82, P < .001], demonstrating a stronger association with an increasing FRID burden-one FRID: aHR 2.81 (95% CI 2.07-3.82, P < .001); ≥5 FRIDs: 5.67 (95% CI 3.70-8.70, P < .001). Long-term FRID prevalence measured pre- and post-fall-related admission was unchanged (53.9%-53.2%). A total of 148 (19.5%) participants had a FRID discontinued, 86 (11.3%) were prescribed an additional FRID and 110 (14.5%) had a FRID initiated for the first time.Conclusion
FRID use, defined via STOPPFall, was prevalent in older adults and associated with a substantially increased risk of injurious falls. FRID use remained unchanged following discharge. Guidelines recommend including medication review in fall-risk assessments, but further work is needed to embed this across health systems.
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BibTeX
@article{gilmore2026fallriskincreasing,
title = {{Fall-risk-increasing drug use in older community-dwelling adults: prevalence, association with fall-related admissions and post-discharge prescribing changes-a retrospective cohort study.}},
author = {Steven Gilmore and Ann Sinéad Doherty and Frank Moriarty and Fiona Boland and Caroline McCarthy and Ryan Muddiman and Barbara Clyne and Tom Fahey and Denis O'Mahony and Emma Wallace},
journal = {Age and ageing},
year = {2026},
month = aug,
doi = {10.1093/ageing/afag303},
url = {https://europepmc.org/article/MED/42912565},
note = {CC BY},
}
RIS
TY - JOUR
TI - Fall-risk-increasing drug use in older community-dwelling adults: prevalence, association with fall-related admissions and post-discharge prescribing changes-a retrospective cohort study.
AU - Steven Gilmore
AU - Ann Sinéad Doherty
AU - Frank Moriarty
AU - Fiona Boland
AU - Caroline McCarthy
AU - Ryan Muddiman
AU - Barbara Clyne
AU - Tom Fahey
AU - Denis O'Mahony
AU - Emma Wallace
PY - 2026
DA - 2026/08/01
JO - Age and ageing
DO - 10.1093/ageing/afag303
UR - https://europepmc.org/article/MED/42912565
AB - Background Fall-risk-increasing drugs (FRIDs) may contribute to a higher falls-risk in older people, but research examining standardised screening tools is limited.Objectives To examine FRID prevalence in community-dwelling older adults, any association with subsequent fall-related hospital admissions, and FRID prescriptions before and after admission.Design Retrospective cohort study.Subjects/setting Adults aged ≥65 years across 44 general practices in Ireland.Methods Fourteen FRIDs, defined by Screening Tool of Older Persons Prescriptions in older adults with high Fall risk (STOPPFall) criteria, were examined as time-varying exposures from 2012 to 2016. The association between FRID exposure and fall-related admissions was estimated using Cox proportional hazards models, adjusted for relevant confounders. Participants' FRID use pre- and post-fall-related admission was analysed descriptively.Findings Of the 35 942 participants, 16 780 (47%) were prescribed at least one long-term FRID at baseline, and 867 (2.4%) experienced a subsequent fall-related admission. Long-term FRID use was associated with a higher risk of fall-related admission [adjusted hazard ratio (aHR) 2.85, 95% CI 2.13-3.82, P < .001], demonstrating a stronger association with an increasing FRID burden-one FRID: aHR 2.81 (95% CI 2.07-3.82, P < .001); ≥5 FRIDs: 5.67 (95% CI 3.70-8.70, P < .001). Long-term FRID prevalence measured pre- and post-fall-related admission was unchanged (53.9%-53.2%). A total of 148 (19.5%) participants had a FRID discontinued, 86 (11.3%) were prescribed an additional FRID and 110 (14.5%) had a FRID initiated for the first time.Conclusion FRID use, defined via STOPPFall, was prevalent in older adults and associated with a substantially increased risk of injurious falls. FRID use remained unchanged following discharge. Guidelines recommend including medication review in fall-risk assessments, but further work is needed to embed this across health systems.
SN - 0002-0729
SN - 1468-2834
ER -