Experts Link Rise in Senior Fall Deaths to Increased Use of Certain Prescription Drugs
Public health researchers point to “fall risk–increasing drugs” as a likely contributor to a threefold rise in U.S. fall-related deaths among older adults over 30 years
The risk of death for older Americans after a fall has roughly tripled over the past three decades, and some public health experts say growing use of certain prescription medications may be a major factor.
Dr. Thomas A. Farley, a Washington, D.C.–based public health expert, wrote in JAMA that changes in lifestyle alone are unlikely to explain the spike and that "there is plenty of reason to believe that the surge in fall deaths may be tied to the soaring use of certain prescription drugs." Researchers in a study published in BMC Geriatrics urged reducing unnecessary use of so-called fall risk–increasing drugs, or FRIDs, as a potentially simple way to lower fall rates and help seniors remain safe and independent.
Officials and clinicians say FRIDs can make older adults more prone to falls by causing drowsiness, dizziness, slowed reaction times or impaired balance and coordination. The Centers for Disease Control and Prevention lists classes of drugs commonly associated with fall risk that include beta-blockers, anticholinergics and proton pump inhibitors, as well as medications that act on the brain and nervous system. Among the most concerning, public health experts have highlighted opioids, benzodiazepines, gabapentinoids such as gabapentin, and antidepressants.
Previous research has shown associations between FRID use and increased fall risk. A Swiss cohort study published last year followed people age 74 and older for three years and found that those taking any FRID had a 13% higher risk of falling, a 15% higher risk of an injurious fall and a 12% higher chance of falling multiple times. Participants taking multiple FRIDs faced higher risks: 22% more total falls and 33% more injurious falls.
Experts cautioned that studies to date show associations rather than definitive causation. Dr. Kenneth J. Perry, a physician in South Carolina, told Fox News Digital that while the links between FRIDs and falls are plausible, proving direct causation requires further research. He emphasized that many medications carry risks but may still be appropriate when their benefits outweigh potential harms.
The increasing prevalence of polypharmacy among older adults complicates assessments of risk. As people age, they are more likely to be prescribed multiple medications for chronic conditions, and interactions among drugs or cumulative side effects can raise the likelihood of dizziness, confusion or impaired mobility. Farley and other researchers have argued that the broad growth in prescribing certain medication classes over recent decades aligns with the timing of the rise in fall-related deaths.
Public health and clinical responses emphasize individualized review rather than blanket avoidance of necessary medicines. Physicians and geriatric specialists recommend medication reconciliation and careful discussion of risks and benefits with primary care providers who understand a patient’s medical history, functional status and fall risk. Deprescribing — the deliberate reduction or discontinuation of medications that may no longer be needed — is increasingly promoted as a strategy to lower medication-related harm, including fall risk.
Nonpharmacologic alternatives and tailored treatment plans are also part of prevention efforts. Interventions such as physical therapy, home safety assessments, vision checks and strength and balance exercises can reduce fall risk without adding medication-related side effects. Clinicians note that for some conditions, safer alternative drugs or lower doses may reduce risk while maintaining therapeutic benefit.
Policy and practice shifts to address medication-related fall risk include expanded geriatric training, routine medication reviews in primary care and long-term care settings, and public health efforts to raise awareness among patients and caregivers. The CDC provides guidance on medications and falls and recommends that clinicians consider medication risk when evaluating older patients who have fallen or are at high risk of falling.
Researchers and clinicians say further studies are needed to quantify how much of the rise in fall-related deaths can be attributed to FRIDs specifically, to identify which medications or combinations carry the greatest risk, and to test interventions that safely reduce reliance on high-risk drugs. Meanwhile, they urge older adults and caregivers to discuss any concerns with health care providers before stopping or changing prescribed medications.
The increase in fall-related mortality among seniors has broad implications as the U.S. population ages. Understanding and addressing medication-related contributors to falls is an element of multifaceted strategies to reduce preventable injuries and improve safety and independence for older adults.