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9/19/2000

Drugs Play Role in Osteoporosis, Falls

Kate Traynor

Medications that contribute to falling episodes or cause secondary osteoporosis can lead to lethal fractures among elderly residents of long-term care facilities.

According to the Centers for Disease Control and Prevention, about half of all U.S. nursing-home residents fall at least one time each year. Nearly 90 percent of all fractures in seniors 65 and older are caused by falling. 

What role do medications play in falling episodes and osteoporosis? A 1995 study published in the American Journal of Epidemiology found that elderly patients who use psychotropic drugs double their risk of repeated falls. Sedatives, anxiolytics, antidepressants, and antihypertensives also predispose the elderly to falls. 

Glucocorticoids, which are commonly used to treat rheumatoid arthritis and chronic obstructive pulmonary disease, can thin the bones and cause secondary osteoporosis. A National Institutes of Health consensus statement, "Osteoporosis Prevention, Diagnosis, and Therapy," also recognizes anticonvulsants as a cause of medication-related osteoporosis among elderly women. The consensus statement, released earlier this year, notes that the use of multiple medications puts nursing-home residents at "particularly high risk" for osteoporotic fracture. 

According to the consensus statement, osteoporotic hip fractures are particularly devastating to nursing-home patients, 20 percent of whom will die within a year of breaking their hip. 

To reduce the risk of osteoporotic fractures, the consensus statement recommends greater use of drugs to prevent and treat osteoporosis. In addition, since osteoporosis drugs work best when patients also take vitamin D and calcium supplements, elderly patients' diets and medications should be monitored.