ArticleJournal of the American Geriatrics Society2017
Central Nervous System Medication Burden and Serious Falls in Older Nursing Home Residents.
Article in Journal of the American Geriatrics Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 65 citations in OpenAlex.
- Association between Drug Therapy and Risk of Incident Frailty: A Systematic Review.Annals of geriatric medicine and research · 2024Pooled it
- Clinical and Economic Outcomes of Interventions to Reduce Antipsychotic and Benzodiazepine Use Within Nursing Homes: A Systematic Review.Drugs & aging · 2018Pooled it
- Impact of CNS medication burden and drug interactions on delirium in patients with advanced cancer: a multicenter prospective observational study.Scientific reports · 2025Observational
- Patterns of Benzodiazepines and Hypnotic Drugs Dispensing After Hip Fracture Among Older US Adults Previously on the Drugs.Journal of the American Geriatrics Society · 2025Article
- Association Between Prehip Fracture Antidepressant Use and Posthip Fracture Length of Hospital Stay in Medicare Beneficiaries and Assessing Sex Differences.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2025Article
- Association of Coprescribing of Gabapentinoid and Other Psychoactive Medications With Altered Mental Status and Falls in Adults Receiving Dialysis.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2025Observational
- Clinical and Adverse Outcomes Associated With Concomitant Use of CYP2D6-Metabolized Opioids With Antidepressants in Older Nursing Home Residents : A Target Trial Emulation Study.Annals of internal medicine · 2024Article
- A comparison of dementia diagnoses and cognitive function measures in Medicare claims and the Minimum Data Set.Journal of the American Geriatrics Society · 2024Article
- Outcomes of Bariatric Surgery in Patients with Schizophrenia.Nutrients · 2024Article
- Central nervous system medication use around hospitalization.Journal of the American Geriatrics Society · 2024Article
- Validating claims-based definitions for deprescribing: Bridging the gap between clinical and administrative data.Pharmacoepidemiology and drug safety · 2024Article
- Developing a rapid predictive model for falls in older hospitalized patients.Frontiers in public health · 2024Observational
- Article
- Antidepressant drug-drug-drug interactions associated with unintentional traumatic injury: Screening for signals in real-world data.Clinical and translational science · 2023Article
- Prescription characteristics associated with fall-related injury risk among older adults prescribed benzodiazepines: a cohort study.BMC geriatrics · 2022Article
- The cross-sectional association of frailty with chronic past and current use of benzodiazepine drugs.Aging clinical and experimental research · 2022Article
- Clinical Utility of Medication-Based Risk Scores to Reduce Polypharmacy and Potentially Avoidable Healthcare Utilization.Pharmaceuticals (Basel, Switzerland) · 2022Article
- Risk of Fall-Related Injuries Associated with Antidepressant Use in Elderly Patients: A Nationwide Matched Cohort Study.International journal of environmental research and public health · 2022Article
- Change in central nervous system-active medication use following fall-related injury in older adults.Journal of the American Geriatrics Society · 2022Article
- Trends in fall-related mortality and fall risk increasing drugs among older individuals in the United States,1999-2017.Pharmacoepidemiology and drug safety · 2021Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
objectivesTo examine the association between CNS medication burden and serious falls in those with a recent fall history.
designNested-case control study; cases matched to four controls by age, gender, and date.
settingUS nursing homes.
participants5,556 residents age ≥65 with a recent fall history admitted to a nursing home between 1/1-9/30/2010 and followed until discharge, death, or December 31, 2010. MEASUREMENTS: Outcome was serious falls as per Medicare Part A and B ICD/CPT codes. CNS burden, from Medicare Part D data, was calculated by dividing the daily dose of each CNS agent (i.e., specific antidepressants, antiepileptic, antipsychotic, benzodiazepine and opioid receptor agonists) received during the 6 days prior to the index (outcome) date by the minimum effective geriatric daily dose and summing the results across medications.
resultsThere were 367 cases and 1,468 matched controls. Those taking 3 + CNS standardized daily doses were more likely to have a serious fall than those not taking any CNS medications (Adjusted Odds Ratio 1.83; 95% confidence interval 1.35-2.48). There was no significant difference in fall risk for residents taking >0 to <3 CNS standardized daily doses compared to residents taking no CNS medications (Adjusted Odds Ratio 0.85; 95% CI 0.63-1.15).
conclusionCNS medication burden, approximately 3 + standardized daily doses, was associated with an increased risk of serious falls in nursing home residents with recent fall. Clinicians should be vigilant for opportunities to discontinue or decrease the doses of individual CNS medications and/or consider non-pharmacological alternatives. Such interventions that reduce use of CNS medications in nursing homes could reduce fall rates but further research is needed to confirm this.
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Registered trials
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