Anticholinergic medication use and falls in postmenopausal women: findings from the women's health initiative cohort study

Zachary A Marcum; Heidi S Wirtz; Mary Pettinger; Andrea Z LaCroix; Ryan Carnahan; Jane A Cauley; Jennifer W Bea; Shelly L Gray

doi:10.1186/s12877-016-0251-0

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Anticholinergic medication use and falls in postmenopausal women: findings from the women's health initiative cohort study

Journal article

Open access

Peer reviewed

Anticholinergic medication use and falls in postmenopausal women: findings from the women's health initiative cohort study

Zachary A Marcum, Heidi S Wirtz, Mary Pettinger, Andrea Z LaCroix, Ryan Carnahan, Jane A Cauley, Jennifer W Bea and Shelly L Gray

BMC geriatrics, Vol.16(1), pp.76-76

04/02/2016

DOI: 10.1186/s12877-016-0251-0

PMCID: PMC4818856

PMID: 27038789

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Abstract

Results from studies assessing the association between anticholinergic use and falls are mixed, and prior studies are limited in their ability to control for important potential confounders. Thus, we sought to examine the association between anticholinergic medication use, including over-the-counter medications, and recurrent falls in community-dwelling older women. We analyzed data from a prospective cohort study of women aged 65 to 79 years from the Women's Health Initiative Observational Study and Clinical Trials. Women were recruited between 1993 and 1998, and analyses included 61,451 women with complete information. Medications with moderate or strong anticholinergic effects were ascertained directly from drug containers during face-to-face interviews. The main outcome measure was recurrent falls (≥2 falls in previous year), which was determined from self-report within 1.5 years subsequent to the medication assessment. At baseline, 11.3 % were using an anticholinergic medication, of which antihistamines (commonly available over-the-counter) were the most common medication class (received by 45.2 % of individuals on anticholinergic medication). Using multivariable GEE models and controlling for potential confounders, the adjusted odds ratio for anticholinergic medication use was 1.51 (95 % CI, 1.43-1.60) for recurrent falls. Participants using multiple anticholinergic medications had a 100 % increase in likelihood of recurrent falls (adjusted odds ratio 2.00, 95 % CI 1.73-2.32). Results were robust to sensitivity analysis. Anticholinergic medication use was associated with increased risk for recurrent falls. Our findings reinforce judicious use of anticholinergic medications in older women. Public health efforts should emphasize educating older women regarding the risk of using over-the-counter anticholinergics, such as first-generation antihistamines.

Recurrence

Prospective Studies

United States

Humans

Middle Aged

Risk Factors

Accidental Falls - statistics & numerical data

Histamine Antagonists - administration & dosage

Histamine Antagonists - adverse effects

Cholinergic Antagonists - administration & dosage

Postmenopause

Female

Aged

Odds Ratio

Cholinergic Antagonists - adverse effects

Cohort Studies

Details

Title: Subtitle: Anticholinergic medication use and falls in postmenopausal women: findings from the women's health initiative cohort study
Creators: Zachary A Marcum - School of Pharmacy, University of Washington, 1959 NE Pacific St, H375G, Box 357630, Seattle, WA, 98195-7630, USA. zmarcum@uw.edu
Heidi S Wirtz - Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, 91320, USA
Mary Pettinger - WHI Clinical Coordinating Center, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, 98109, USA
Andrea Z LaCroix - Division of Epidemiology, UC San Diego, 9500 Gilman Dr #0725, La Jolla, CA, 92093, USA
Ryan Carnahan - College of Public Health, Department of Epidemiology, University of Iowa, 145 N Riverside Dr, 100 CPHB, Iowa City, IA, 52242, USA
Jane A Cauley - Department of Epidemiology, University of Pittsburgh, A510 Crabtree Hall, Pittsburgh, PA, 15261, USA
Jennifer W Bea - Departments of Medicine and Nutritional Sciences, University of Arizona Cancer Center, 1515 N Campbell Ave, PO Box 245024, Tucson, AZ, 85724, USA
Shelly L Gray - School of Pharmacy, University of Washington, 1959 NE Pacific St, H375G, Box 357630, Seattle, WA, 98195-7630, USA
Resource Type: Journal article
Publication Details: BMC geriatrics, Vol.16(1), pp.76-76
DOI: 10.1186/s12877-016-0251-0
PMID: 27038789
PMCID: PMC4818856
NLM abbreviation: BMC Geriatr
ISSN: 1471-2318
eISSN: 1471-2318
Publisher: England
Grant note: P30 AG024827 / NIA NIH HHS HHSN268201100046C / NHLBI NIH HHS HHSN268201100002I / NHLBI NIH HHS HHSN271201100004C / NIA NIH HHS HHSN268201100001C / WHI NIH HHS HHSN268201100004I / NHLBI NIH HHS HHSN268201100002C / WHI NIH HHS HHSN268201100001I / NHLBI NIH HHS HHSN268201100003C / WHI NIH HHS T32 AG021885 / NIA NIH HHS HHSN268201100004C / WHI NIH HHS
Language: English
Date published: 04/02/2016
Academic Unit: Epidemiology; Injury Prevention Research Center
Record Identifier: 9983995132702771

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