The Association Between the Number of Prescription Medications and Incident Falls in a Multi-ethnic Population of Adult Type-2 Diabetes Patients: The Diabetes and Aging Study
Open accessAbstract
Background Use of four or more prescription medications is considered a risk factor for falls in older people. It is unclear whether this polypharmacy-fall relationship differs for adults with diabetes.Objective We evaluated the association between number of prescription medications and incident falls in a multi-ethnic population of type-2 diabetes patients in order to establish an evidence-based medication threshold for fall risk in diabetes.Design Baseline survey (1994-1997) with 5 years of longitudinal follow-up.Participants Eligible subjects (N = 46,946) had type-2 diabetes, were >or=18 years old, and enrolled in the Kaiser Permanente Northern California Diabetes Registry.Measurements and main results We identified clinically recognized incident falls based on diagnostic codes (ICD-9 codes: E880-E888). Relative to regimens of 0-1 medications, regimens including 4 or more prescription medications were significantly associated with an increased risk of falls [4-5 medications adjusted HR 1.22 (1.04, 1.43), 6-7 medications 1.33 (1.12, 1.58), >7 medications 1.59 (1.34, 1.89)]. None of the individual glucose-lowering medications was found to be significantly associated with a higher risk of falls in predictive models.Conclusions The prescription of four or more medications was associated with an increased risk of falls among adult diabetes patients, while no specific glucose-lowering agent was linked to increased risk. Baseline risk of falls and number of baseline medications are additional factors to consider when deciding whether to intensify diabetes treatments.
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In one study, polypharmacy (use of 6 or more prescription medications) was associated with increased risk of falling in older people.
“In one study, polypharmacy (defined as use of 6 or more prescription medications) was associated with increased risk of falling in older people75.”
From Diabetes in Older Adults: A Consensus Report (2012) · cites this paper as [75]
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Diabetes in Older Adults: A Consensus Report
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- Authors
- Huang, E. S., Karter, A. J., Danielson, K. K., Warton, E. M., & Ahmed, A. T.
- Affiliations
- University of Chicago (US)
- Kaiser Permanente (US)
- Corresponding author
- Huang, Elbert S.
- Venue
- Journal of General Internal Medicine
- Published
- 2009-12-05
- Volume
- 25
- Issue
- 2
- Pages
- 141-146
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC2837501
- OpenAlex
- W2088665197
- Cited by
- 140
- References
- 28
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 7 · 2022: 6 · 2021: 8 · 2020: 6 · 2019: 17 · 2018: 15 · 2017: 8 · 2016: 5 · 2015: 11 · 2014: 20 · 2013: 14 · 2012: 12
- FWCI
- 4.50
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (K23AG021963)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK081796, P60DK020595, R01DK065664)
- National Institute of Child Health and Human Development
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD046113)
- 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
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Keywords
- polypharmacy, falls, type 2 diabetes, prescription drugs, fall risk, glucose-lowering agents, older adults, multi-ethnic population
- MeSH terms
- Accidental Falls, Adolescent, Adult, Aged, Aged, 80 and over, Aging, Diabetes Mellitus, Type 2, Ethnicity, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Middle Aged, Predictive Value of Tests, Drug Prescriptions, Registries, Risk Factors, Incidence, Polypharmacy, Young Adult
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