Psychotropic drugs and the risk of fall injuries, hospitalisations and mortality among older adults
Open accessAbstract
Objective To investigate whether psychotropics are associated with an increased risk of fall injuries, hospitalizations, and mortality in a large general population of older adults. Methods We performed a nationwide matched (age, sex, and case event day) case–control study between 1 January and 31 December 2011 based on several Swedish registers (n = 1,288,875 persons aged ≥65 years). We used multivariate conditional logistic regression adjusted for education, number of inpatient days, Charlson co‐morbidity index, dementia and number of other drugs. Results Antidepressants were the psychotropic most strongly related to fall injuries (ORadjusted: 1.42; 95% CI: 1.38–1.45) and antipsychotics to hospitalizations (ORadjusted: 1.22; 95% CI: 1.19–1.24) and death (ORadjusted: 2.10; 95% CI: 2.02–2.17). Number of psychotropics was associated with increased the risk of fall injuries, (4 psychotropics vs 0: ORadjusted: 1.53; 95% CI: 1.39–1.68), hospitalization (4 psychotropics vs 0: ORadjusted: 1.27; 95% CI: 1.22–1.33) and death (4 psychotropics vs 0: ORadjusted: 2.50; 95% CI: 2.33–2.69) in a dose–response manner. Among persons with dementia (n = 58,984), a dose–response relationship was found between number of psychotropics and mortality risk (4 psychotropics vs 0: ORadjusted: 1.99; 95% CI: 1.76–2.25). Conclusions Our findings support a cautious prescribing of multiple psychotropic drugs to older patients. © 2016 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons, Ltd.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In older adults, psychotropic use has been associated with risk of severe adverse effects such as falls, stroke and mortality.
“In older adults, psychotropic use has been associated with the risk of severe adverse effects such as falls [13–18], stroke [17, 19–22] and mortality [13, 23–25].”
From Stakeholders' views on the use of psychotropic medication in older people: a systematic review (2022) · cites this paper as [13]
The Discussion’s Main findings report an association between psychotropic drug use and fall injuries and mortality among older adults. The paper does not report an association with stroke, so it supports only part of the attributed claim. No page number is available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987) · Journal of Chronic Diseases · doi:10.1016/0021-9681(87)90171-8 · Cited by 49,742 · see citing works
External review and validation of the Swedish national inpatient register
Ludvigsson, J. F., Andersson, E., Ekbom, A., Feychting, M., Kim, J.-L., Reuterwall, C., Heurgren, M., & Olausson, P. O. (2011) · BMC Public Health · doi:10.1186/1471-2458-11-450 · Cited by 5,055 · see citing works
Wettermark, B., Hammar, N., MichaelFored, C., Leimanis, A., Olausson, P. O., Bergman, U., Persson, I. R., Sundström, A., Westerholm, B., & Rosén, M. (2006) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.1294 · Cited by 1,868 · see citing works
Meta-analysis of the Impact of 9 Medication Classes on Falls in Elderly Persons
Woolcott, J. C. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2009.357 · Cited by 1,326 · cited 1× · see citing works
“Since then, reviews have established use of psychotropics as a risk factor for falls (Bloch et al., 2011; Woolcott et al., 2009).”
BackgroundAntidepressant use and risk of adverse outcomes in older people: population based cohort study
Coupland, C., Dhiman, P., Morriss, R., Arthur, A., Barton, G., & Hippisley-Cox, J. (2011) · BMJ · doi:10.1136/bmj.d4551 · Cited by 833 · see citing works
Schneeweiß, S. (2001) · American Journal of Epidemiology · doi:10.1093/aje/154.9.854 · Cited by 712 · see citing works
Maust, D. T., Kim, H. M., Seyfried, L. S., Chiang, C., Kavanagh, J., Schneider, L. S., & Kales, H. C. (2015) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2014.3018 · Cited by 617 · see citing works
Biased Selection of Controls for Case-Control Analyses of Cohort Studies
Lubin, J. H., & Gail, M. H. (1984) · Biometrics · doi:10.2307/2530744 · Cited by 414 · see citing works
The prevalence of mental disorders in older people in Western countries – a meta-analysis
Volkert, J., Schulz, H., Härter, M., Wlodarczyk, O., & Andreas, S. (2013) · Ageing Research Reviews · doi:10.1016/j.arr.2012.09.004 · Cited by 390 · see citing works
Risk of Mortality Among Individual Antipsychotics in Patients With Dementia
Kales, H. C., Kim, H. M., Zivin, K., Valenstein, M., Seyfried, L. S., Chiang, C., Cunningham, F., Schneider, L. S., & Blow, F. C. (2012) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2011.11030347 · Cited by 384 · see citing works
Medication-Related Falls in the Elderly
Huang, A. R., Mallet, L., Rochefort, C. M., Eguale, T., Buckeridge, D. L., & Tamblyn, R. M. (2012) · Drugs & Aging · doi:10.2165/11599460-000000000-00000 · Cited by 345 · see citing works
Huybrechts, K. F., Gerhard, T., Crystal, S., Olfson, M., Avorn, J., Levin, R., Lucas, J. A., & Schneeweiß, S. (2012) · BMJ · doi:10.1136/bmj.e977 · Cited by 264 · see citing works
The clinical implications of ageing for rational drug therapy
Shi, S., Mörike, K., & Klotz, U. (2008) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-007-0422-1 · Cited by 244 · see citing works
Antipsychotic Therapy and Short-term Serious Events in Older Adults With Dementia
Rochon, P. A. (2008) · Archives of Internal Medicine · doi:10.1001/archinte.168.10.1090 · Cited by 235 · see citing works
American Geriatrics Society and American Association for Geriatric Psychiatry (2003) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.2003.51415.x · Cited by 210 · see citing works
RODRIGUES, L., & KIRKWOOD, B. R. (1990) · International Journal of Epidemiology · doi:10.1093/ije/19.1.205 · Cited by 207 · see citing works
Unintentional falls mortality among elderly in the United States: Time for action
Alamgir, H., Muazzam, S., & Nasrullah, M. (2012) · Injury · doi:10.1016/j.injury.2011.12.001 · Cited by 190 · see citing works
Psychotropic Drugs and Falls in the Elderly People: Updated Literature Review and Meta-Analysis
Bloch, F., Thibaud, M., Dugué, B., Brèque, C., Rigaud, A., & Kemoun, G. (2010) · Journal of Aging and Health · doi:10.1177/0898264310381277 · Cited by 170 · see citing works
Adverse Drug Events as a Cause of Hospitalization in Older Adults
Salvi, F., Marchetti, A., D’Angelo, F., Boemi, M., Lattanzio, F., & Cherubini, A. (2012) · Drug Safety · doi:10.1007/bf03319101 · Cited by 148 · see citing works
Inappropriate Drug Use in the Elderly: a Nationwide Register-Based Study
Johnell, K., Fastbom, J., Rosén, M., & Leimanis, A. (2007) · Annals of Pharmacotherapy · doi:10.1345/aph.1k154 · Cited by 120 · see citing works
Self-citationIs group psychotherapy effective in older adults with depression? A systematic review
Krishna, M., Jauhari, A., Lepping, P., Turner, J., Crossley, D., & Krishnamoorthy, A. (2011) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2546 · Cited by 111 · see citing works
A systematic review of research examining benzodiazepine-related mortality
Charlson, F., Degenhardt, L., McLaren, J., Hall, W., & Lynskey, M. (2009) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.1694 · Cited by 107 · see citing works
Drug Treatment as a Cause of Falls in Old Age
Campbell, A. J. (1991) · Drugs & Aging · doi:10.2165/00002512-199101040-00005 · Cited by 101 · see citing works
Diagnosis and Treatment of Depression in Older Community‐Dwelling Adults: 1992–2005
Akıncıgil, A., Olfson, M., Walkup, J. T., Siegel, M. J., Kalay, E., Amin, S., Zurlo, K. A., & Crystal, S. (2011) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2011.03447.x · Cited by 83 · see citing works
Johnell, K., & Fastbom, J. (2012) · Drugs & Aging · doi:10.1007/s40266-012-0002-7 · Cited by 74 · see citing works
Self-citationJohnell, K., & Fastbom, J. (2009) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2189 · Cited by 73 · see citing works
Self-citationKarlin, B. E., Trockel, M., Brown, G. K., Gordienko, M., Yesavage, J. A., & Taylor, C. B. (2013) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbt096 · Cited by 65 · see citing works
Physician Willingness to Refer Older Depressed Patients for Psychotherapy
Alvidrez, J., & Areán, P. A. (2002) · The International Journal of Psychiatry in Medicine · doi:10.2190/j26t-yqmj-bf83-m05d · Cited by 54 · see citing works
Gustafsson, M. V., Sandman, P., Karlsson, S., Gustafson, Y., & Lövheim, H. (2013) · International Psychogeriatrics · doi:10.1017/s1041610213000859 · Cited by 47 · see citing works
The use of psychotropics and survival in demented elderly individuals
Hartikainen, S. A., Rahkonen, T., Kautiainen, H., & Sulkava, R. O. (2005) · International Clinical Psychopharmacology · doi:10.1097/00004850-200507000-00006 · Cited by 25 · see citing works
Johnell, K., Laflamme, L., Möller, J., & Monárrez‐Espino, J. (2014) · PLoS ONE · doi:10.1371/journal.pone.0086742 · Cited by 21 · see citing works
Self-citationWastesson, J. W., Weitoft, G. R., & Johnell, K. (2014) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12378 · Cited by 21 · see citing works
Self-citationWastesson, J. W., Fastbom, J., Weitoft, G. R., Fors, S., & Johnell, K. (2014) · European Journal of Public Health · doi:10.1093/eurpub/cku058 · Cited by 10 · see citing works
Self-citationOlder adults recently started on psychotropic medication: where are the symptoms?
Maust, D. T., Chen, S. H., Benson, A., Mavandadi, S., Streim, J. E., DiFilippo, S. D., Snedden, T. M., & Oslin, D. W. (2014) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4187 · Cited by 6 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Antidepressant medications in dementia: evidence and potential mechanisms of treatment-resistance
Costello, H., Roiser, J. P., & Howard, R. (2023) · Psychological Medicine · doi:10.1017/s003329172200397x · Cited by 60 · see citing works
Stakeholders' views on the use of psychotropic medication in older people: a systematic review
Bednarczyk, E., Cook, S., Brauer, R., & Garfield, S. (2022) · Age and Ageing · doi:10.1093/ageing/afac060 · Cited by 22 · see citing works
Characteristics and Outcome Determinants of Hospitalized Older Patients with Cognitive Dysfunction
Chao, Y.-T., Kuo, F.-H., Lee, Y.-S., Huang, Y.-H., Weng, S.-C., Chou, Y.-Y., Lin, C.-S., & Lin, S.-Y. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19010584 · Cited by 14 · see citing works
Bajracharya, R., & Qato, D. M. (2021) · Journal of Aging and Health · doi:10.1177/0898264320959293 · Cited by 5 · see citing works
- Authors
- Johnell, K., Jonasdottir Bergman, G., Fastbom, J., Danielsson, B., Borg, N., & Salmi, P.
- Affiliations
- Stockholm University (SE)
- The Swedish National Board of Health and Welfare (Socialstyrelsen) Stockholm Sweden
- National Board of Health and Welfare (SE)
- Corresponding author
- Johnell, Kristina
- Venue
- International Journal of Geriatric Psychiatry
- Publisher
- Wiley
- Published
- 2016-04-25
- Volume
- 32
- Issue
- 4
- Pages
- 414-420
- ISSN
- 0885-6230 (ISSN-L)
- 1099-1166
- PMC
- PMC5347947
- OpenAlex
- W2343691934
- Cited by
- 130
- References
- 34
- Citations by year
- 2026: 11 · 2025: 13 · 2024: 11 · 2023: 6 · 2022: 13 · 2021: 19 · 2020: 22 · 2019: 15 · 2018: 10 · 2017: 9 · 2016: 1
- FWCI
- 6.70
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- International Journal of Geriatric Psychiatry (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Vetenskapsrådet
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Keywords
- psychotropic drugs, fall-related injuries, hospitalization, mortality, older adults, antidepressants, antipsychotic drugs, polypharmacy, dementia, dose-response relationship, drug prescribing
- MeSH terms
- Accidental Falls, Aged, Aged, 80 and over, Antidepressive Agents, Mental Disorders, Female, Hospitalization, Humans, Male, Mortality, Psychotropic Drugs, Sweden, Antipsychotic Agents, Comorbidity, Logistic Models, Case-Control Studies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
