Medication side effects should always be reviewed for fall risk because many drugs can impair balance, cognition, blood pressure regulation, and sensory perception, all of which are critical to maintaining stability and preventing falls. Falls are a major health concern, especially for older adults, and medication-induced side effects are a significant, yet often overlooked, contributor to fall risk.
Medications can cause dizziness, drowsiness, confusion, blurred vision, and muscle weakness—side effects that directly increase the likelihood of losing balance and falling. For example, sedatives, antidepressants, antipsychotics, and certain blood pressure medications can lower alertness or cause orthostatic hypotension (a sudden drop in blood pressure upon standing), leading to lightheadedness and falls. Anticholinergic drugs, which are common in older adults, can cause confusion and impaired coordination, further elevating fall risk. The more medications a person takes, the higher the chance of interactions that worsen these side effects, compounding the danger.
Older adults are particularly vulnerable because aging naturally reduces muscle strength, slows reflexes, and impairs vision and hearing. When combined with medication side effects, these age-related changes create a perfect storm for falls. For instance, medications like diphenhydramine (Benadryl) can cause confusion and sedation in seniors, increasing fall risk. Similarly, drugs used to treat dementia or depression, such as donepezil or citalopram, have been linked to higher fall rates. This is why healthcare providers use tools like the Beers Criteria to identify medications that may be inappropriate or risky for older adults.
Regularly reviewing medications with a healthcare provider helps identify drugs that may be contributing to fall risk. Adjusting dosages, switching to safer alternatives, or discontinuing unnecessary medications can reduce side effects and improve safety. Electronic medication systems in care facilities can track anticholinergic load and alert providers when a patient’s medication profile increases fall risk, enabling timely interventions.
Beyond medication review, fall prevention involves a holistic approach: maintaining muscle strength and balance through exercise, ensuring home environments are free of hazards, and managing vision or hearing impairments. But medication review is a critical piece because it addresses a modifiable risk factor that can otherwise be hidden or underestimated.
In short, medication side effects should always be reviewed for fall risk because they can subtly but significantly impair the physical and cognitive functions necessary to stay upright. Proactive medication management is essential to prevent falls, protect independence, and improve quality of life, especially in older adults who are most susceptible to these risks.