Medication-related falls in the elderly: mechanisms and prevention strategies.

Accidental falls represent a major public health concern for the elderly population. The use of psychotropic medications, cardiovascular medications, and nonsteroidal anti-inflammatory drugs is associated with an increased risk of falling. The mechanisms by which these medications increase fall risk are not fully understood but may include orthostatic hypotension, sedation, sleep disturbance, confusion, dizziness, and other central nervous system problems. A better understanding of these mechanisms may help guide pharmacists' interventions in reducing falls by educating patients, monitoring symptoms, adjusting doses, or discontinuing drugs implicated in falls. This article provides a discussion of the mechanisms by which certain classes of medications may contribute to falls and pharmacotherapeutic recommendations for preventing them.