How does polypharmacy cause falls?

Polypharmacy has long been thought to be linked to increased incidence of falls. A recent Canadian cohort study assessing community‐dwelling older adults included 5 years of follow‐up to assess this issue amongst people aged 65 years and older (n = 249; 76.6 ± 8.6 y; 63% women). The study assessed the number of medications used, quantitative spatiotemporal gait parameters, and fall incidence during follow‐up. More medications used by older people was associated with poor gait performance (slow gait, speed p < .001; higher variability, p < .001; and higher stride, p < .001; step, p = .013, and double support times, p < .001). Prospectively, the number of medications was associated with overall gait decline (odds ratio = 1.23; 95% confidence interval [CI] = 1.13‐1.33; p < .001), faster gait decline (hazard ratio = 4.62; 95%CI = 1.82‐11.73; p < .001), and higher falls incidence (p = .006). Each additional medication taken significantly increased gait decline risk by 12% to 16% and fall incidence risk by 5% to 7%. Mediation analyses revealed that gait impairments in stride length, step length, and step width mediated the strength of the association between medications and fall incidence. An excellent study that provides real insight into the concrete impact of extensive medication use upon falls, which can be viewed here