ArticleAge and ageing2025
Medications associated with dizziness or hypotension and adverse outcomes: an electronic health record study in older adults with dementia.
Article in Age and ageing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundComorbidities and polypharmacy are common in people with dementia, leading to a higher risk of adverse outcomes. While the impact of anticholinergic properties has been extensively investigated, less is known about other cross-category properties of medications.
objectiveTo investigate whether medications with dizziness or hypotension as a side effect are associated with adverse outcomes in older adults with dementia.
designRetrospective cohort study. SETTING AND
participantsFrom a South London catchment, 15 210 patients diagnosed with dementia between 2008 and 2017.
methodsMedications with dizziness and/or hypotension listed as a side effect were compiled and quantified in the cohort. Multivariable Cox regression models were run to determine the risk of mortality, all-cause emergency hospitalisation and hospitalisation due to falls. Generalised estimating equations were applied to investigate cognitive decline. The final model adjusted for 19 potential confounders, including physical and mental health measures.
resultsOf the patients, 82.2% were receiving at least one dizziness-associated medication and 71.2% at least one hypotension-associated medication. For each additional medication associated with dizziness or hypotension, there was a 4% increased risk of all-cause emergency hospitalisation. No associations were found with hospitalised falls specifically or with mortality or cognitive decline.
conclusionMedications that potentially cause dizziness or hypotension were associated with an increased risk of hospitalisation, although not specifically hospitalisation caused by falls. More systematic attention should be paid to coprescribing around the time of dementia diagnosis and the potential for rationalising this to minimise adverse drug events.
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