Effects of medications on balance and mobility
In addition to certain medical conditions, both the type and the number of medications prescribed to older adults contribute to heightened fall risk. It has been demonstrated that older adults who are taking more than four prescription medications are four times more likely to sustain a fall when compared with peers who are taking fewer prescription medications (Tinetti, 2003; Neutel, Perry, & Maxwell, 2002). In addition, specific types of medications have been shown to elevate fall risk in older adults (Leipzig et al., 1999a). Side effects such as dizziness, reduced alertness, weakness, fatigue, and postural hypotension that result from taking these medications are all likely contributors to heightened fall risk.
Given that most, if not all, of the clients enrolled in your balance and mobility program will be taking one or more prescription medications, you need to ask prospective program participants to provide you with the names of all their medications and the medical condition for which the drugs were prescribed. Although numerous research studies have identified many individual medications that increase the risk for falling due to their effects on CNS function, little is known about how the interactive or additive effects of taking multiple medications might further affect balance and mobility. The classes of medications that are positively associated with increased fall risk include most classes of psychotropic drugs, such as tricyclic antidepressants, neuroleptics, sedatives and hypnotics, and benzodiazepines (both long and short acting). Table 2.2 summarizes adverse effects associated with certain types of medications that are likely to increase the risk for falling.