POLYPHARMACY AND RISK OF FALLS IN COMMUNITY-DWELLING OLDER ADULTS: A CROSS-SECTIONAL STUDY

Abstract

Background: Falls among older adults are a leading cause of injury, disability, and mortality. Polypharmacy, commonly defined as the concurrent use of five or more medications, is increasingly prevalent in elderly populations and has been implicated as a potential risk factor for falls, particularly in community-dwelling individuals.

Objective: To evaluate the association between polypharmacy and the incidence of recent falls among elderly individuals living independently in community settings.

Methods: A cross-sectional study was conducted over eight months in urban and semi-urban areas of Punjab, Pakistan. A total of 500 community-dwelling individuals aged 65 years or older were recruited through multistage sampling. Data on medication use, fall history (past 6 months), cognitive status (MMSE), and functional mobility (Timed Up and Go test) were collected via structured interviews. Polypharmacy was defined as the use of ≥5 medications. Chi-square and multivariate logistic regression were applied to determine the association between polypharmacy and fall incidence, adjusting for confounders.

Results: Out of 500 participants, 240 (48%) were identified with polypharmacy. The fall incidence was significantly higher in the polypharmacy group (32.5%) compared to those using fewer medications (12.3%). Higher fall rates were also observed in participants with poor mobility and cognitive impairment. Polypharmacy remained an independent predictor of falls even after adjusting for age, comorbidities, mobility, and cognition (p<0.001).

Conclusion: Polypharmacy is significantly associated with increased fall risk in community-dwelling older adults. Targeted deprescribing and medication reviews should be prioritized to reduce fall-related morbidity and promote safer aging in place.