‘Too many drugs’ for elderly

Elderly people taking high-risk sleeping and pain medications are twice as likely to fall and break bones, with up to a third dying within a year of being injured, new research shows.

The world-leading study from the University of Otago, measured the impact of taking multiple medications on fractures in the elderly.

It found the side effects of some commonly prescribed drugs – such as those used to treat sleep conditions, pain and incontinence – reacted with others to create ‘‘additional effects’’, causing falls. About 90 per cent of fractures suffered by elderly people are the result of a fall and between 20 and 30 per cent of elderly who broke their hip died within a year.

Medications linked with ‘‘significantly increasing’’ the risk of broken bones usually had sedatory side effects, or caused a dry mouth, blurred vision, dizziness and confusion, the study found.

In a two-year period, about 3 per cent of all New Zealanders aged over-65 would fall and break their hip.

Christchurch researcher and geriatrician Dr Hamish Jamieson, who led the study, said people taking three or more ‘‘drug burden index’’ medications – medications that sedate or affect a person’s cognition – were twice as likely to break their hip than those taking no medications.

Up 40 to 50 per cent of over-60s were on at least one of these medicines.

Currently, more than 2000 New Zealanders a year break their hips. Jamieson said a broken hip was a major injury that took a ‘‘massive’’ amount of energy for the body to heal.

‘‘The impacts can be subtle but this can cause a major impact in the frail elderly and can cause falls, loss of independence and even premature death.’’

Age Concern chief executive Stephanie Clare said it was not uncommon for elderly people to take a variety of medications a day, and the types could ‘‘quickly add up’’.

‘‘They could have a couple of medications for a heart condition, maybe diabetes and kidney problems . . . add to that nonprescription medications like vitamins and fish-oil tablets, it can be a lot.’’

She said it was important patients, their GPs and pharmacists regularly reviewed what medications were being taken and ensured they were still needed. People sometimes continued to take drugs they no longer needed simply because they had not been told to stop, she said.

‘‘People need to really understand what they’re taking, it’s not just the blue one at midday and the pink one in the afternoon. It’s about asking, ‘what is this for and why do I need it?’,’’ she said.

Clare said for some elderly people, the fear of falling was so severe they chose not to leave the house.

Jamieson said one in seven New Zealanders are 65 and over and the impact of fractures on individuals and the community was ‘‘immense’’, resulting in loss of mobility, poorer quality of life and early entry into aged care facilities.

More than 200,000 ACC claims for injuries sustained in falls were made by people aged over 60 in the year ending June.

More than 20,000 of those falls resulted in fractures and dislocations.

Falls Prevention Service nurse Jan Creelman said geriatricians were trying to cut doses down for their patients.

Prescriptions for pain medication and sleeping tablets were ‘‘massively decreasing’’ and used only as a last resort.

Uneven footpaths, sudden changes in direction and people hurrying to answer the phone were major problems.