Falls are a leading cause of injury and loss of independence in older adults.
Several medicine classes increase the risk, especially when combined.
Key concepts
- Sedative sleeping pills are a major fall risk
- Bring all medicines (including over-the-counter) to every review
- Never stop medicines suddenly — taper under guidance
Symptoms and signs
- Dizziness on standing
- Unsteady walking, especially at night
- Daytime drowsiness or confusion
Causes
- Sedatives and sleeping pills
- Some antidepressants, antipsychotics and anti-allergy medicines
- Blood pressure and diabetes medicines causing low BP or low sugar
Risk factors
- Taking five or more medicines
- Weak vision or poor lighting
- Getting up at night to urinate
Evidence-based management
- Medicine review every 6–12 months
- Lowest effective doses and fewer sedating medicines
- Night lights, grab bars, non-slip mats
- Balance and strength exercises
When to seek professional help
- Families can book an online consultation and join the call with the elder
- A fall or near-fall after starting a new medicine
- Sudden confusion, weakness or slurred speech — go to an emergency department now
Frequently asked questions
My parent has taken sleeping pills for years — is it harmful?
Long-term use increases falls and memory problems; a gradual supervised reduction is usually advised.
Who should do the medicine review?
The treating physician or psychiatrist, with a full list of all medicines.
Medical references
Guidelines and official sources used for this article.
- Delirium: prevention, diagnosis and management (CG103). NICE, UK, 2010.
- Dementia — fact sheet. World Health Organization.
- Author
- Dr. Kuldeep Budania, MBBS, MD Psychiatry
- Medical reviewer
- Dr. Kuldeep Budania, MD Psychiatry
- Last reviewed
This article is for general information and is not a substitute for personal medical advice.
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