Prevalence and association of fall-risk-increasing drugs (FRIDs) with fall-related head and non-head injuries in older adults: a retrospective database study

Falls are a leading cause of morbidity and mortality in older adults, with head injuries posing significant risk. Fall-risk-increasing drugs (FRIDs) contribute to falls, but their relationship with head injuries remains unclear. This observational, cross-sectional study aimed to examine the prevalence of fall-risk-increasing drug (FRID) use and the association between specific FRID classes and fall-related head injuries in older adults. We analyzed medical records of 1,085 adults aged ≥ 60 years who presented with falls at a tertiary hospital in Northern Thailand between January and December 2023. Of these, 47.1% sustained head injuries and 71.7% used FRIDs. The most frequently used FRIDs were opioids (33.0%), anticholinergics (26.8%), and antihistamines (22.5%). Multivariable logistic regression revealed that Z-drugs (aOR = 3.09, 95% CI: 1.15-8.26, p = 0.025), antipsychotics (aOR = 2.75, 95% CI: 1.40-5.39, p = 0.003), and benzodiazepines (aOR = 1.76, 95% CI: 1.16-2.66, p = 0.008) were positively associated with head injuries. Conversely, anticholinergics (aOR = 0.54, 95% CI: 0.40-0.72, p < 0.001) and opioids (aOR = 0.39, 95% CI: 0.30-0.51, p < 0.001) showed negative associations. These findings emphasize the need for careful medication management to prevent serious fall-related outcomes in geriatric populations.