Age UK. Falls in later life: a huge concern for older people. 2019. https// (accessed 20 September 2023)

Age UK. Getting a good night's sleep. 2022. https// (accessed 20 September 2023)

Andrade C. Sedative hypnotics and the risk of falls and fractures in the elderly. J Clin Psychiatry. 2018; 79:(3)

Arthur A, Savva GM, Barnes LE Changing prevalence and treatment of depression among older people over two decades. Br J Psychiatry. 2020; 216:(1)49-54

Budnitz DS, Lovegrove MC, Shehab N, Richards CL. Emergency hospitalizations for adverse drug events in older Americans. N Engl J Med. 2011; 365:(21)2002-2012

American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023; 71:(7)2052-2081

Cahir C, Fahey T, Teeling M, Teljeur C, Feely J, Bennett K. Potentially inappropriate prescribing and cost outcomes for older people: a national population study. Br J Clin Pharmacol. 2010; 69:(5)543-552

Chumney EC, Robinson LC. The effects of pharmacist interventions on patients with polypharmacy. Pharm Pract (Granada). 2006; 4:(3)103-109

Coleman JJ, Pontefract SK. Adverse drug reactions. Clin Med (Lond). 2016; 16:(5)481-485

Collamati A, Martone AM, Poscia A Anticholinergic drugs and negative outcomes in the older population: from biological plausibility to clinical evidence. Aging Clin Exp Res. 2016; 28:(1)25-35

Coupland CAC, Hill T, Dening T, Morriss R, Moore M, Hippisley-Cox J. Anticholinergic Drug Exposure and the Risk of Dementia: A Nested Case-Control Study. JAMA Intern Med. 2019; 179:(8)1084-1093

Curtin D, Gallagher P, O'Mahony D. Deprescribing in older people approaching end-of-life: development and validation of STOPP Frail version 2. Age Ageing. 2021; 50:(2)465-471

Darowski A, Chambers SA, Chambers DJ. Antidepressants and falls in the elderly. Drugs Aging. 2009; 26:(5)381-394

Davies LE, Spiers G, Kingston A, Todd A, Adamson J, Hanratty B. Adverse outcomes of polypharmacy in older people: systematic review of reviews. J Am Med Dir Assoc. 2020; 21:(2)181-187

Department of Health and Social Care. Matt Hancock orders review into over-prescribing in the NHS. 2018. https// (accessed 21 September 2023)

Distefano G, Goodpaster BH. Effects of exercise and aging on skeletal muscle. Cold Spring Harb Perspect Med. 2018; 8:(3)

Dumic I, Nordin T, Jecmenica M Gastrointestinal tract disorders in older age. Can J Gastroenterol Hepatol. 2019; 2019

Duncan P, Cabral C, McCahon D, Guthrie B, Ridd MJ. Efficiency versus thoroughness in medication review: a qualitative interview study in UK primary care. Br J Gen Pract. 2019; 69:(680)e190-e198

Electronic Medicines Compendium. Verapamil hydrochloride. 2023. https//

Fisher H, Zabar S, Chodosh J A novel simulation-based approach to training for recruitment of older adults to clinical trials. BMC Med Res Methodol. 2022; 22:(1)

Fox C, Richardson K, Maidment ID Anticholinergic medication use and cognitive impairment in the older population: the medical research council cognitive function and ageing study. J Am Geriatr Soc. 2011; 59:(8)1477-1483

Gao L, Maidment I, Matthews FE, Robinson L, Brayne C Medication usage change in older people (65+) in England over 20 years: findings from CFAS I and CFAS II. Age Ageing. 2018; 47:(2)220-225

Garza AZ, Park SB, Kocz R. Drug elimination.Treasure Island (FL): StatPearls Publishing; 2022

Gray SL, Anderson ML, Dublin S Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study. JAMA Intern Med. 2015; 175:(3)401-407

Grossi CM, Richardson K, Savva GM Increasing prevalence of anticholinergic medication use in older people in England over 20 years: cognitive function and ageing study I and II. BMC Geriatr. 2020; 20:(1)

Hedna K, Hakkarainen KM, Gyllensten H Potentially inappropriate prescribing and adverse drug reactions in the elderly: a population-based study. Eur J Clin Pharmacol. 2015; 71:(12)1525-1533

Herzig SJ, Anderson TS, Jung Y Relative risks of adverse events among older adults receiving opioids versus NSAIDs after hospital discharge: A nationwide cohort study. PLoS Med. 2021; 18:(9)

Jennison T, Brinsden M. Fracture admission trends in England over a ten-year period. Ann R Coll Surg Engl. 2019; 101:(3)208-214

Jung YS, Suh D, Choi HS, Park HD, Jung SY, Suh DC. Risk of fall-related injuries associated with antidepressant use in elderly patients: a nationwide matched cohort study. Int J Environ Res Public Health. 2022; 19:(4)

Kim IH, Kisseleva T, Brenner DA. Aging and liver disease. Curr Opin Gastroenterol. 2015; 31:(3)184-191

Kingston A, Robinson L, Booth H, Knapp M, Jagger C Projections of multi-morbidity in the older population in England to 2035: estimates from the Population Ageing and Care Simulation (PACSim) model. Age Ageing. 2018; 47:(3)374-380

Koren G, Nordon G, Radinsky K, Shalev V. Clinical pharmacology of old age. Expert Rev Clin Pharmacol. 2019; 12:(8)749-755

Liew TM, Lee CS, Goh Shawn KL, Chang ZY. Potentially inappropriate prescribing among older persons: a meta-analysis of observational studies. Ann Fam Med. 2019; 17:(3)257-266

Maidment I, Booth A, Mullan J, McKeown J, Bailey S, Wong G. Developing a framework for a novel multi-disciplinary, multi-agency intervention(s), to improve medication management in community-dwelling older people on complex medication regimens (MEMORABLE)—a realist synthesis. Syst Rev. 2017; 6:(1)

Marcum ZA, Perera S, Thorpe JM Antidepressant use and recurrent falls in community-dwelling older adults: findings from the Health ABC study. Ann Pharmacother. 2016; 50:(7)525-33

Masnoon N, Shakib S, Kalisch-Ellett L What is polypharmacy? A systematic review of definitions. BMC Geriatr. 2017; 17

National Institute for Health and Care Excellence. Multimorbidity: clinical assessment and management. NICE guideline [NG56]. 2016. https// (accessed 21 September 2023)

National Institute for Health and Care Excellence. Impact: falls and fragility fractures. 2018. https// (accessed 21 September 2023)

NHS Digital. Quality and Outcomes Framework 2020-21. 2022. https// (accessed 21 September 2023)

Nishtala PS, Salahudeen MS, Hilmer SN. Anticholinergics: theoretical and clinical overview. Expert Opin Drug Saf. 2016; 15:(6)753-768

Office for National Statistics. People with long-term health conditions, UK: January to December 2019. 2020. https// (accessed 21 September 2023)

O'Mahony D, Gallagher PF. Inappropriate prescribing in the older population: need for new criteria. Age Ageing. 2008; 37:(2)138-141

O'Mahony D, O'Sullivan D, Byrne S, O'Connor MN, Ryan C, Gallagher P. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age Ageing. 2015; 44:(2)213-8

Opondo D, Eslami S, Visscher S, de Rooij SE, Verheij R, Korevaar JC, Abu-Hanna A. Inappropriateness of medication prescriptions to elderly patients in the primary care setting: a systematic review. PLoS One. 2012; 7:(8)

Oscanoa TJ, Lizaraso F, Carvajal A. Hospital admissions due to adverse drug reactions in the elderly. A meta-analysis. Eur J Clin Pharmacol. 2017; 73:(6)759-770

Parsons C. Polypharmacy and inappropriate medication use in patients with dementia: an underresearched problem. Therapeutic advances in drug safety. 2017; 8:(1)31-46

Richardson K, Bennett K, Maidment ID, Fox C, Smithard D, Kenny RA. Use of medications with anticholinergic activity and self-reported injurious falls in older community-dwelling adults. J Am Geriatr Soc. 2015; 63:(8)1561-1519

Ryba N, Rainess R. Z-drugs and Falls: A focused review of the literature. Sr Care Pharm. 2020; 35:(12)549-554

Seppala LJ, Kamkar N, van Poelgeest EP Medication reviews and deprescribing as a single intervention in falls prevention: a systematic review and meta-analysis. Age Ageing. 2022; 51:(9)

Sönnerstam E, Sjölander M, Gustafsson M. Inappropriate prescription and renal function among older patients with cognitive impairment. Drugs Aging. 2016; 33:(12)889-899

Veeren JC, Weiss M. Trends in emergency hospital admissions in England due to adverse drug reactions: 2008–2015. Journal of Pharmaceutical Health Services Research. 2017; 8:(1)5-11

Weeks G, George J, Maclure K, Stewart D. Non-medical prescribing versus medical prescribing for acute and chronic disease management in primary and secondary care. Cochrane Database Syst Rev. 2016; 11:(11)

World Health Organization. Medication Safety in Polypharmacy. 2019. https// (accessed 21 September 2023)

World Health Organization. Promoting rational use of medicines. 2022. https// (accessed 21 September 2023)

Can medication increase the risk of falls? The importance of medication review

02 November 2023
Volume 28 · Issue 11


Falls are the second leading cause of unintentional injury deaths worldwide and are a major health issue for older people. One of the factors that can increase the risk of falls is medication. This article examines how medication can affect fall risk and how medication review can reduce the risk of falls.

Each year, 3 million people aged 65 years and over fall and 5 000 people die as result of the fall (National Institute for Health and Care Excellence (NICE), 2018; Age UK, 2019). Ageing increases the risk of falls and of sustaining an injury when a fall occurs. People aged 80 years and over are more likely to incur a fracture when they fall (NICE, 2018; Jennison and Brinsden, 2019). On average, 248 000 people in England are admitted to hospital annually because of fractures caused by falls (Jennison and Brinsden, 2019).

As people age, they are more likely to develop long-term conditions. In the UK, around 19 million people have long-term conditions (Office for National Statistics (ONS), 2020). When a person has two or more long-term health conditions, this is known as multimorbidity (NICE, 2016). The prevalence of comorbidities and multimorbidity is rising in line with population ageing and growing levels of ill-health and long-term conditions in younger people (Kingston et al, 2018). The latest data is reported to be less accurate than usual due to the impact of the COVID-19 pandemic (NHS Digital, 2022).

Register now to continue reading

Thank you for visiting Community Nursing and reading some of our peer-reviewed resources for district and community nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • New content and clinical newsletter updates each month