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Withdrawal of Fall-Risk-Increasing Drugs in Older Persons

Effect on Mobility Test Outcomes

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Abstract

Background

Previously, we have shown that withdrawal of fall-risk-increasing drugs (FRIDs) as a single intervention reduces falls incidence. Improvement of mobility may be an important factor in this finding and we therefore tested whether mobility tests improved after FRID withdrawal.

Methods

In a prospective cohort study of 137 geriatric outpatients (age 77.7 ± 5.7 years), FRIDs were withdrawn in all fallers, if possible, between April 2003 and November 2004. All patients underwent mobility testing at baseline, including a 10m walking test (WT), Timed ‘Up & Go’ Test (TUGT), Functional Reach Test (FRT), isometric quadriceps femoris muscle strength and a body sway test. Retesting occurred at a mean follow-up of 6.7 months. The effect of FRID withdrawal (discontinuation or dose reduction) on test outcomes was calculated using both multivariate linear and binary logistic regression analyses.

Results

In the group of fallers with FRID withdrawal all mobility tests improved, as opposed to non-fallers and fallers without FRID withdrawal. After adjustment for confounders, the odds ratio of no improvement was 0.14 (95% CI 0.03, 0.59) for the TUGT, 0.19 (95% CI 0.04,0.86) for the 10m WT, 0.48 (95% CI 0.14, 1.57) for the FRT, 0.46 (95% CI 0.14, 1.48) for the quadriceps strength test and 0.49 (95% CI 0.15, 1.62) for the body sway test.

Conclusion

The results of this study suggest that FRID withdrawal may be effective as a single intervention in a geriatric setting. In addition to reducing falls (as shown in our previous study), FRID withdrawal significantly improved 10m WT and TUGT results over a mean follow-up period of 6.7 months. These tests may therefore be useful tools for monitoring the clinical effect of FRID withdrawal.

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Acknowledgements

We thank Erasmus University Medical Center, Merck Sharp & Dohme and Will-Pharma for funding the present project. The study’s sponsors had no role in the design and conduct of the study, in the collection, analysis and interpretation of the data, or in the preparation, review or approval of the manuscript.

The authors have no conflicts of interest that are directly relevant to the content of this study.

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Authors and Affiliations

  1. Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands

    Nathalie van der Velde, Bruno H. Ch. Stricker, Huibert A. P. Pols &  Tischa J. M. van der Cammen (Head)

  2. Section of Geriatric Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands

    Nathalie van der Velde &  Tischa J. M. van der Cammen (Head)

  3. Department of Epidemiology and Biostatistics, Erasmus University Medical Center, Rotterdam, The Netherlands

    Nathalie van der Velde & Bruno H. Ch. Stricker

Authors
  1. Nathalie van der Velde
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  2. Bruno H. Ch. Stricker
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  3. Huibert A. P. Pols
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  4. Tischa J. M. van der Cammen
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Correspondence to Tischa J. M. van der Cammen.

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van der Velde, N., Stricker, B.H.C., Pols, H.A.P. et al. Withdrawal of Fall-Risk-Increasing Drugs in Older Persons. Drugs Aging 24, 691–699 (2007). https://doi.org/10.2165/00002512-200724080-00006

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