Evidence map›Paper›PMID 37331981›Full record

ArticleBMC geriatrics2023

Association of medication use with falls and mortality among long-term care residents: a longitudinal cohort study.

Hanna-Maria Roitto, Ulla L Aalto, Hanna Öhman, Riitta K T Saarela, Hannu Kautiainen, Karoliina Salminen, Kaisu H Pitkälä

Open access · goldAbstract read
In one paragraph

Article in BMC geriatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 3 pooled it
3.2field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 3 syntheses or guidelines pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Review
  5. Observational
  6. Observational
  7. Review
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 2 countries.

Hanna-Maria RoittoDepartment of Geriatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. hanna-maria.roitto@hel.fi.ORCID 0000-0002-5466-2873
Ulla L AaltoDepartment of Geriatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Hanna ÖhmanDepartment of Geriatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Riitta K T SaarelaDepartment of Social Services and Health Care, Helsinki, Finland.
Hannu KautiainenDepartment of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.
Karoliina SalminenDepartment of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.
Kaisu H PitkäläDepartment of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.
University of Helsinki · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFalls in long-term care are common. The aim of our study was to explore how medication use is associated with incidence of falls, related consequences, and all-cause mortality among long-term care residents.

methodsFive hundred thirty two long-term care residents aged 65 years or older participated in this longitudinal cohort study in 2018-2021. Data on medication use were retrieved from medical records. Polypharmacy was defined as use of 5-10 medications and excessive polypharmacy as use of > 10 medications. The numbers of falls, injuries, fractures, and hospitalizations were collected from medical records over 12 months following baseline assessment. Participants were followed for three years for mortality. All analysis were adjusted for age, sex, Charlson Comorbidity Index, Clinical dementia rating, and mobility.

resultsA total of 606 falls occurred during the follow-up. Falls increased significantly with the number of medications used. Fall rate was 0.84/person-years (pyrs) (95% CI 0.56 to 1.13) for the non-polypharmacy group, 1.13/pyrs (95% CI 1.01 to 1.26) for the polypharmacy group, and 1.84/pyrs (95% CI 1.60 to 2.09) for the excessive polypharmacy group. Incidence rate ratio for falls was 1.73 (95% CI 1.44 to 2.10) for opioids, 1.48 (95% CI 1.23 to 1.78) for anticholinergic medication, 0.93 (95% CI 0.70 to 1.25) for psychotropics, and 0.91 (95% CI 0.77 to 1.08) for Alzheimer medication. The three-year follow-up showed significant differences in mortality between the groups, the lowest survival rate (25%) being in the excessive polypharmacy group.

conclusionPolypharmacy, opioid and anticholinergic medication use predicted incidence of falls in long-term care. The use of more than 10 medications predicted all-cause mortality. Special attention should be paid to both number and type of medications when prescribing in long-term care.

Indexed as

Accidental FallsLong-Term CareCholinergic AntagonistsCohort StudiesHumansLongitudinal StudiesRisk FactorsCholinergic AntagonistsFallsLong-term careMortalityPolypharmacy

Identifiers

PMID37331981
PMCPMC10278366
OpenAlexW4381122224

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.