Postural Instability and Consequent Falls and Hip Fractures Associated with Use of Hypnotics in the Elderly

@article{Allain2005PosturalIA,
  title={Postural Instability and Consequent Falls and Hip Fractures Associated with Use of Hypnotics in the Elderly},
  author={Herv{\'e} Allain and Dani{\`e}le Bentu{\'e}‐Ferrer and Elisabeth Polard and Yvette Akwa and Alain A. Patat},
  journal={Drugs \& Aging},
  year={2005},
  volume={22},
  pages={749-765}
}
The aim of this review is to establish the relationship between treatment with hypnotics and the risk of postural instability and as a consequence, falls and hip fractures, in the elderly.A review of the literature was performed through a search of the MEDLINE, Ingenta and PASCAL databases from 1975 to 2005. We considered as hypnotics only those drugs approved for treating insomnia, i.e. some benzodiazepines and the more recently launched ‘Z’-compounds, i.e. zopiclone, zolpidem and zaleplon… 
The Association in Elderly Hospitalized Patients, Between Psychotropic Drugs and Hip Fractures Resulting from Falls
TLDR
The rate of psychotropic drug use in general and their anticholinergic burden are similar in acutely admitted elderly patients with or without hip fractures, however, higher usage rate of anxiolytics found in the patients with hip fractures may indicate that this is a risk factor for hip fractures related to falls in elderly patients living in the community.
Sleep, insomnia and falls in elderly patients.
Insomnia and risk of falling in older adults.
TLDR
The pharmacologic treatment of insomnia in elderly patients and the underlying mechanisms of hypnotic medication-related falls appear to be related to psychomotor impairment, loss of balance, and next-day residual effects.
Use of non-benzodiazepine sedative hypnotics and risk of falls in older men.
TLDR
Use of non-pharmacologic approaches to sleep disturbances may represent the safest approach to sleep difficulties in older adults and is associated with an increased risk of falls.
Effects of Potent Anticholinergics, Sedatives and Antipsychotics on Postoperative Mortality in Elderly Patients with Hip Fracture
TLDR
In men, use of potent anticholinergics was associated with excess age-adjusted mortality at 30 days, 3 months, 6 months and 3 years, but not in women at any timepoint, while in women, presence of cardiovascular disease and chronic lung disease independently predicted excess mortality.
Z-drugs and risk for falls and fractures in older adults—a systematic review and meta-analysis
TLDR
It is indicated that Z-drugs are associated with an increased risk for fractures, and suggest a possible increase risk for falls and injuries as well, and Physicians should consider these potential risks before prescribing these medications in older adults.
Risk of hip fracture among older people using anxiolytic and hypnotic drugs: a nationwide prospective cohort study
TLDR
Older people had an increased risk of hip fracture during anxiolytic or hypnotic drug use, including short-acting benzodiazepine anxio-lytics and z-hypnotics that were previously considered less harmful; cautious prescribing is therefore needed.
Use of short-acting and long-acting hypnotics and the risk of fracture: a critical analysis of associations in a nationwide cohort
TLDR
It was showed that the highest risk of fracture was found before start of treatment and remained after end of therapy, suggesting that the increased risk during treatment is influenced by other factors, such as underlying disease.
Medication Use and Increased Risk of Falls in Hospitalized Elderly Patients
TLDR
Some drugs are associated with an increased risk of falls in the elderly and, when alternatives exist, should be avoided until cohort studies are conducted to confirm or refute these possible increased risks.
Pharmacologic therapy and the impact on falls in the elderly
  • H. B. Levy
  • Medicine
    Expert review of clinical pharmacology
  • 2008
TLDR
The event of an unintentional fall can have devastating effects on patients, resulting in death, hip fracture or other injury, nursing home admission and increased medical costs.
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