# Relating consequential falls to individual and combinations of prescription medication use in Swedish older adults

## TL;DR

This study explores how prescription medications, both individually and in combination, relate to consequential falls in older Swedish adults.

## Contribution

The study identifies specific medications and drug combinations associated with increased risk of consequential falls in older adults.

## Key findings

- Angiotensin II receptor blockers and diuretics were significantly linked to consequential falls.
- Platelet aggregation inhibitors combined with cardiovascular drugs increased fall risk.
- Six drug combinations were found to significantly relate to fall incidence.

## Abstract

We assessed the relationship between prescription of medications (both individually and in combination) and consequential falls.

Medication prescription and prospectively registered falls over 2.5 years were extracted from 441 participants within a Swedish National Quality Register. Conditional generalized estimating equations, considering dependence of longitudinal data as a cluster to correct confidence intervals, were used to relate medications (individual and in combination) and falls.

Regarding individual-medications, Angiotensin II receptor blockers and diuretics (C09DA) were significantly related to incidence of consequential falls (p = 0.022). Six drug combinations significantly related to fall incidence. Most frequently, falls were observed when platelet aggregation inhibitors (B01AC) were prescribed with C09DA, opioids (N02AA), or blood glucose lowering drugs (biguanides, A10BA).

Caution should be taken when prescribing cardiovascular medications. Further, prescription of platelet aggregation inhibitors could increase the incidence of a negative outcome of a fall when prescribed in people at risk for falls.

The online version contains supplementary material available at 10.1007/s00228-026-04000-2.

The relationships between combinations of medications and rates of injurious falls is poorly understood.

We addressed this gap using prospectively collected falls and medication data from a Swedish National Registry.

Cardiovascular and platelet aggregation inhibitor medications related to consequential falls in this well-characterized cohort of older adults.

The online version contains supplementary material available at 10.1007/s00228-026-04000-2.