Antidepressant Use and Recurrent Falls in Community-Dwelling Older Adults

Findings From the Health ABC Study

Zachary A. Marcum, Subashan Perera, Joshua M. Thorpe, Galen E. Switzer, Nicholas G. Castle, Elsa S. Strotmeyer, Eleanor M. Simonsick, Hilsa N. Ayonayon, Caroline L. Phillips, Susan Rubin, Audrey Zucker-Levin, Douglas C. Bauer, Ronald I. Shorr, Yihuang Kang, Shelly L. Gray, Joseph T. Hanlon

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: Few studies have compared the risk of recurrent falls across various antidepressant agents—using detailed dosage and duration data—among community-dwelling older adults, including those who have a history of a fall/fracture. Objective: To examine the association of antidepressant use with recurrent falls, including among those with a history of falls/fractures, in community-dwelling elders. Methods: This was a longitudinal analysis of 2948 participants with data collected via interview at year 1 from the Health, Aging and Body Composition study and followed through year 7 (1997-2004). Any antidepressant medication use was self-reported at years 1, 2, 3, 5, and 6 and further categorized as (1) selective serotonin reuptake inhibitors (SSRIs), (2) tricyclic antidepressants, and (3) others. Dosage and duration were examined. The outcome was recurrent falls (≥2) in the ensuing 12-month period following each medication data collection. Results: Using multivariable generalized estimating equations models, we observed a 48% greater likelihood of recurrent falls in antidepressant users compared with nonusers (adjusted odds ratio [AOR] = 1.48; 95% CI = 1.12-1.96). Increased likelihood was also found among those taking SSRIs (AOR = 1.62; 95% CI = 1.15-2.28), with short duration of use (AOR = 1.47; 95% CI = 1.04-2.00), and taking moderate dosages (AOR = 1.59; 95% CI = 1.15-2.18), all compared with no antidepressant use. Stratified analysis revealed an increased likelihood among users with a baseline history of falls/fractures compared with nonusers (AOR = 1.83; 95% CI = 1.28-2.63). Conclusion: Antidepressant use overall, SSRI use, short duration of use, and moderate dosage were associated with recurrent falls. Those with a history of falls/fractures also had an increased likelihood of recurrent falls.

Original languageEnglish (US)
Pages (from-to)525-533
Number of pages9
JournalAnnals of Pharmacotherapy
Volume50
Issue number7
DOIs
StatePublished - Jul 1 2016

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Independent Living
Antidepressive Agents
Odds Ratio
Health
Serotonin Uptake Inhibitors
Tricyclic Antidepressive Agents
Body Composition
Interviews

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this

Marcum, Z. A., Perera, S., Thorpe, J. M., Switzer, G. E., Castle, N. G., Strotmeyer, E. S., ... Hanlon, J. T. (2016). Antidepressant Use and Recurrent Falls in Community-Dwelling Older Adults: Findings From the Health ABC Study. Annals of Pharmacotherapy, 50(7), 525-533. https://doi.org/10.1177/1060028016644466

Antidepressant Use and Recurrent Falls in Community-Dwelling Older Adults : Findings From the Health ABC Study. / Marcum, Zachary A.; Perera, Subashan; Thorpe, Joshua M.; Switzer, Galen E.; Castle, Nicholas G.; Strotmeyer, Elsa S.; Simonsick, Eleanor M.; Ayonayon, Hilsa N.; Phillips, Caroline L.; Rubin, Susan; Zucker-Levin, Audrey; Bauer, Douglas C.; Shorr, Ronald I.; Kang, Yihuang; Gray, Shelly L.; Hanlon, Joseph T.

In: Annals of Pharmacotherapy, Vol. 50, No. 7, 01.07.2016, p. 525-533.

Research output: Contribution to journalArticle

Marcum, ZA, Perera, S, Thorpe, JM, Switzer, GE, Castle, NG, Strotmeyer, ES, Simonsick, EM, Ayonayon, HN, Phillips, CL, Rubin, S, Zucker-Levin, A, Bauer, DC, Shorr, RI, Kang, Y, Gray, SL & Hanlon, JT 2016, 'Antidepressant Use and Recurrent Falls in Community-Dwelling Older Adults: Findings From the Health ABC Study', Annals of Pharmacotherapy, vol. 50, no. 7, pp. 525-533. https://doi.org/10.1177/1060028016644466
Marcum, Zachary A. ; Perera, Subashan ; Thorpe, Joshua M. ; Switzer, Galen E. ; Castle, Nicholas G. ; Strotmeyer, Elsa S. ; Simonsick, Eleanor M. ; Ayonayon, Hilsa N. ; Phillips, Caroline L. ; Rubin, Susan ; Zucker-Levin, Audrey ; Bauer, Douglas C. ; Shorr, Ronald I. ; Kang, Yihuang ; Gray, Shelly L. ; Hanlon, Joseph T. / Antidepressant Use and Recurrent Falls in Community-Dwelling Older Adults : Findings From the Health ABC Study. In: Annals of Pharmacotherapy. 2016 ; Vol. 50, No. 7. pp. 525-533.
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abstract = "Background: Few studies have compared the risk of recurrent falls across various antidepressant agents—using detailed dosage and duration data—among community-dwelling older adults, including those who have a history of a fall/fracture. Objective: To examine the association of antidepressant use with recurrent falls, including among those with a history of falls/fractures, in community-dwelling elders. Methods: This was a longitudinal analysis of 2948 participants with data collected via interview at year 1 from the Health, Aging and Body Composition study and followed through year 7 (1997-2004). Any antidepressant medication use was self-reported at years 1, 2, 3, 5, and 6 and further categorized as (1) selective serotonin reuptake inhibitors (SSRIs), (2) tricyclic antidepressants, and (3) others. Dosage and duration were examined. The outcome was recurrent falls (≥2) in the ensuing 12-month period following each medication data collection. Results: Using multivariable generalized estimating equations models, we observed a 48{\%} greater likelihood of recurrent falls in antidepressant users compared with nonusers (adjusted odds ratio [AOR] = 1.48; 95{\%} CI = 1.12-1.96). Increased likelihood was also found among those taking SSRIs (AOR = 1.62; 95{\%} CI = 1.15-2.28), with short duration of use (AOR = 1.47; 95{\%} CI = 1.04-2.00), and taking moderate dosages (AOR = 1.59; 95{\%} CI = 1.15-2.18), all compared with no antidepressant use. Stratified analysis revealed an increased likelihood among users with a baseline history of falls/fractures compared with nonusers (AOR = 1.83; 95{\%} CI = 1.28-2.63). Conclusion: Antidepressant use overall, SSRI use, short duration of use, and moderate dosage were associated with recurrent falls. Those with a history of falls/fractures also had an increased likelihood of recurrent falls.",
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AU - Switzer, Galen E.

AU - Castle, Nicholas G.

AU - Strotmeyer, Elsa S.

AU - Simonsick, Eleanor M.

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