Polypharmacy in elderly impairs gait leading to falls and disability

Canada: The concurrent use of multiple medications (5 or more regular prescriptions) -- called polypharmacy, may impair gait in elderly resulting in falls, disability and death, according to a recent study published in the Journal of the American Geriatrics Society.

Polypharmacy has been linked to fall incidence in various studies, and recently it has been shown to be linked to cross‐sectionally associated with gait disturbances. Manuel Montero‐Odasso, Parkwood Institute and Lawson Health Research Institute, London, Ontario, Canada, and colleagues evaluated cross‐sectional and longitudinal associations between polypharmacy and gait performance in a well‐established clinic‐based cohort study. They also assessed whether gait impairments could mediate associations between the number of medications and fall incidence.

For the purpose, the Canadian researchers prospectively evaluated gait patterns among 249 older adults (age, ≥65) without gait-impairing neurological diagnoses.

Key findings of the study include:

• At baseline, the 176 patients who were taking more than five medications (mean, 9 prescriptions) were older, had more diagnosed illnesses, reported more falls in the previous year, and (on formal gait testing) walked considerably more slowly and haltingly than the other 73 patients.


• During 5 years of follow-up, gait parameters worsened more rapidly in the high-med group, even after controlling for age and comorbidity.


• The number of medications was associated with overall gait decline, faster gait decline, and higher falls incidence


• 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.