"This book summarizes the current knowledge and research evidence about the potentially detrimental effects of medications on fall risk. ... The book is appropriate for a wide range of audiences interested in the care of older adults, from healthcare providers and researchers to policy makers and family members. ... This is useful as a reference for practitioners caring for older adults and concerned about fall risk and prevention, particularly related to commonly prescribed medications in this population." (Lorraine J. Phillips, Doody's Book Reviews, November, 2016)
Part 1.- 1. Introduction.- 2. The Aging Population and Falls: Consequences and Costs.- 3. Falls Count and Counting Falls: Making Sense of Data About Falls.- Part 2. Drugs and Falls: Why are Older People at Risk?.- 4. Polypharmacy.- 5. Pharmacology of Drugs in Aging.- 6. Age-Related Physical and Physiologic Changes and Co-Morbidities in Older People: Association with Falls.- 7. Adverse Events & Falls.- 8. Risk Factors for Falls in the Elderly.- Part 3. Medications Associated with Falls in the Elderly.- 9. Psychotropic Drugs.- 10. Benzodiazepines.- 11. Drugs for Degenerative Neurologic Conditions: Antiparkinson Medications, Cholinesterase Inhibitors and Memantine.- 12. Antihypertensive and Cardiovascular Medications.- 13. Glucose Control Medications.- Part 4. Management of Medication-Related Falls.- 14. Inappropriate Medications and Risk of Falls in Older Adults.- 15. Identifying Explicit Criteria for the Prevention of Falls.- 16. Approach to Medication Reviews in Older Adults.- 17. Withdrawal of Falls-Risk Increasing Drugs.- 18. Benzodiazepines Withdrawal in the Elderly: A Practical Approach.- 19. Role of Information and Communication Technologies.- 20. A Novel Personalized Falls Risk Calculator Tool: A Prototype for Improving the Safety of Prescribing Through Computerized Decision Support.- 21. Future Directions.
Allen R. Huang is the Chief of Geriatric Medicine at the University of Ottawa and The Ottawa Hospital. He is a fellow of the Royal College of Physicians and Surgeons of Canada, the American College of Physicians and the American Geriatrics Society. He also serves on the board of the Canadian Geriatrics Society. His research interest is in the field of optimal prescribing for older people. He has published 40 papersand two book chapters. He serves on the editorial boards of Drugs and Aging and Journal of Population Therapeutics and Clinical Pharmacology. He is the recipient of the 2003 Qualcomm CDMA A-List award in the non-profit, impact category and the 2006 Prix J.-Armand-Bombardier award for innovation from the Association canadienne-francaise pour l’avancement des sciences.
Louise Mallet is a professor at the Faculty of Pharmacy, University of Montréal, Montréal, Québec, Canada and a clinical pharmacist on the geriatric consult team in the emergency room at McGill University Health Centre, Glen site. Her primary research interest is inappropriate medication usage in elderly patients. She has published numerous papers, presented at conferences, and acted as co-editor of two French-language textbooks on medications in the elderly. She is a member of the editorial review board for The Consultant Pharmacist journal and is associate editor for the French journal Pharmactuel. Dr. Mallet is a recipient of the Roger LeBlanc award, the Excellence in Geriatric Pharmacy Practice award from the American Society of Consultant pharmacists, and the prestigious award Prix Louis Hébert from the Quebec pharmaceutical Society. She has also been honoured by the Association des pharmaciens en établissements du santé du Québec for her work as a hospital pharmacist. She is a Fellow of the European Society of Clinical Pharmacy.
Comprising a single repository of knowledge and scientific evidence in the field, this book provides strategies to mitigate fall risk by providing information on the complex interactions between aging processes, co-morbid conditions and prescribed medications in older patients.
Geriatric health is becoming a more prominent issue as the population ages, and balancing the beneficial effects of medication against the potential and real side-effects in these patients involves a deliberate and thoughtful task: physiologic aging, the accumulation of co-morbidities, and the use of drugs to manage various conditions and symptoms generates a unique set of problems for each patient.
Falls are a dreaded event in older people. The event can affect a person in a physical, and psychological manner, resulting in soft tissue and bony injury, fear of falling, and depression. The identification of and reduction in fall risks in older people is a worldwide concern, and reducing the incidence of falls is a ubiquitous quality measure of health care delivery. Heterogeneity amongst older people precludes a single solution. However, physicians and others involved in the care of geriatric patients will benefit from the presented insights into how medication use can be modified to limit its impact as a contributing factor.