US fall mortality rises — are prescription drugs to blame?
The fall mortality rate among older adults in the U.S. has more than tripled over the last 30 years, despite steadily decreasing in other high-income countries, according to an opinion paper published Aug. 8 in JAMA Health Forum.
One possible explanation for the discrepancy could be the higher level of prescription drug use in older U.S. adults, Thomas Farley, MD, an epidemiologist and author of the paper, said.
“From 2017 to 2020, 90% of adults older than 65 years were taking prescription drugs, 43% were taking multiple prescription drugs and 45% were taking prescription drugs that were ‘potentially inappropriate,’” he said.
A 2020 review of 14 studies found that among older adults injured from falls, 65% to 93% were taking at least one fall risk-increasing drug, or a “FRID.”
Across four categories of FRIDs — opioids, benzodiazepines, gabapentinoids and antidepressants — prescription rates have varied over the past few decades, Dr. Farley said.
The 2023 National Survey on Drug Use and Health found that 32% of adults older than 65 years had taken prescription pain relievers, such as opioids, and 17% had taken prescription tranquilizers or sedatives, such as benzodiazepines. Between 2006 and 2018, prescriptions for gabapentin or a combination of gabapentin and opioids increased about fourfold. The percentage of older adults prescribed antidepressants has also increased from 8% to 20% from 1999 to the start of the COVID-19 pandemic.
Some experts said the increase in falls cannot solely be attributed to prescription drugs, according to a Sept. 7 report from The New York Times. The report cites changes to cause of death reporting and the increased overall life expectancy as two possible contributing factors to the growing fall mortality rate.
Read the full opinion paper here and the full Times report here.
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