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Association between Antidepressants and Fall-Related Injuries among Long-Term Care Residents.
Am J Geriatr Psychiatry. 2017 Dec; 25(12):1326-1336.AJ

Abstract

OBJECTIVES

Antidepressants are associated with an increased risk of falls although little is known of the comparative risks of different types of antidepressants or individuals who are at greatest risk for falls. We examined the association between new use of antidepressants and fall-related injuries among older adults in long-term care (LTC).

DESIGN, SETTING, PARTICIPANTS

This was a matched, retrospective cohort study involving LTC residents in Ontario, Canada, from 2008 to 2014. New users of antidepressants were matched to non-users of antidepressants.

MEASUREMENTS

The primary outcome was any fall resulting in an emergency department (ED) visit or hospitalization within 90 days after exposure. Secondary outcomes included hip fractures, wrist fractures, and falls reported in LTC. Multivariate logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval associated with antidepressants and outcomes.

RESULTS

New users of any antidepressant had an increased risk of ED visits or hospitalization for falls within 90 days when compared with individuals not receiving antidepressants (5.2% versus 2.8%; adjusted OR: 1.9, 95% CI: 1.7-2.2). Antidepressants were also associated with an increased risk of all secondary outcomes. The increased risk of fall-related injuries was evident among selective-serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, trazodone, and across multiple patient subgroups.

CONCLUSIONS

New use of antidepressants is associated with significantly increased risk of falls and fall-related injuries among LTC residents across different patient subgroups and antidepressant classes. The potential risk of fall-related outcomes should be carefully considered when initiating antidepressants among older adults in LTC.

Authors+Show Affiliations

Department of Psychiatry, Queen's University, Providence Care-Mental Health Services, Kingston, Canada; Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada; Department of Public Health, Queen's University, Kingston, Canada.Department of Psychiatry, University of Toronto, Toronto Rehabilitation Institute, Toronto, Canada.Department of Psychiatry, Queen's University, Providence Care-Mental Health Services, Kingston, Canada.Schools of Pharmacy and Public Health and Health Systems, University of Waterloo, Waterloo, Canada.Department of Medicine, Queen's University, Kingston, Canada.Department of Psychiatry, Western University, London, Canada.Institute for Clinical Evaluative Sciences, Queen's University, London, Canada.Department of Psychiatry, Queen's University, Providence Care-Mental Health Services, Kingston, Canada; Institute for Clinical Evaluative Sciences, Queen's University, London, Canada. Electronic address: seitzd@providencecare.ca.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28943234

Citation

Macri, Jennifer C., et al. "Association Between Antidepressants and Fall-Related Injuries Among Long-Term Care Residents." The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, vol. 25, no. 12, 2017, pp. 1326-1336.
Macri JC, Iaboni A, Kirkham JG, et al. Association between Antidepressants and Fall-Related Injuries among Long-Term Care Residents. Am J Geriatr Psychiatry. 2017;25(12):1326-1336.
Macri, J. C., Iaboni, A., Kirkham, J. G., Maxwell, C., Gill, S. S., Vasudev, A., Whitehead, M., & Seitz, D. P. (2017). Association between Antidepressants and Fall-Related Injuries among Long-Term Care Residents. The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, 25(12), 1326-1336. https://doi.org/10.1016/j.jagp.2017.08.014
Macri JC, et al. Association Between Antidepressants and Fall-Related Injuries Among Long-Term Care Residents. Am J Geriatr Psychiatry. 2017;25(12):1326-1336. PubMed PMID: 28943234.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between Antidepressants and Fall-Related Injuries among Long-Term Care Residents. AU - Macri,Jennifer C, AU - Iaboni,Andrea, AU - Kirkham,Julia G, AU - Maxwell,Colleen, AU - Gill,Sudeep S, AU - Vasudev,Akshya, AU - Whitehead,Marlo, AU - Seitz,Dallas P, Y1 - 2017/09/01/ PY - 2017/05/11/received PY - 2017/08/11/revised PY - 2017/08/24/accepted PY - 2017/9/26/pubmed PY - 2018/6/28/medline PY - 2017/9/26/entrez KW - Falls KW - antidepressants KW - drug safety KW - fall-related injuries KW - long-term care KW - older adults SP - 1326 EP - 1336 JF - The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry JO - Am J Geriatr Psychiatry VL - 25 IS - 12 N2 - OBJECTIVES: Antidepressants are associated with an increased risk of falls although little is known of the comparative risks of different types of antidepressants or individuals who are at greatest risk for falls. We examined the association between new use of antidepressants and fall-related injuries among older adults in long-term care (LTC). DESIGN, SETTING, PARTICIPANTS: This was a matched, retrospective cohort study involving LTC residents in Ontario, Canada, from 2008 to 2014. New users of antidepressants were matched to non-users of antidepressants. MEASUREMENTS: The primary outcome was any fall resulting in an emergency department (ED) visit or hospitalization within 90 days after exposure. Secondary outcomes included hip fractures, wrist fractures, and falls reported in LTC. Multivariate logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval associated with antidepressants and outcomes. RESULTS: New users of any antidepressant had an increased risk of ED visits or hospitalization for falls within 90 days when compared with individuals not receiving antidepressants (5.2% versus 2.8%; adjusted OR: 1.9, 95% CI: 1.7-2.2). Antidepressants were also associated with an increased risk of all secondary outcomes. The increased risk of fall-related injuries was evident among selective-serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, trazodone, and across multiple patient subgroups. CONCLUSIONS: New use of antidepressants is associated with significantly increased risk of falls and fall-related injuries among LTC residents across different patient subgroups and antidepressant classes. The potential risk of fall-related outcomes should be carefully considered when initiating antidepressants among older adults in LTC. SN - 1545-7214 UR - https://www.unboundmedicine.com/medline/citation/28943234/Association_between_Antidepressants_and_Fall_Related_Injuries_among_Long_Term_Care_Residents_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1064-7481(17)30446-3 DB - PRIME DP - Unbound Medicine ER -