Late-life sleep medication use associated with increased falls risk in the Atherosclerosis Risk in Communities (ARIC) study.

Abstract

Objective: Accidental falls are the leading cause of injury for older adults in the United States. Identifying risk factors for falls is a public health priority. Poor sleep is prevalent among aging adults and has been linked to falls risk. We examined late-life sleep medication use and falls risk in a cohort of older adults.

Methods: The Atherosclerosis Risk in Communities (ARIC) study is an ongoing community-based cohort study. ARIC participants taking any barbiturates, benzodiazepines, antidepressants, non-benzodiazepine receptor agonists, or other hypnotics in the past 4 weeks (2011-2013) were categorized as taking a medication that affects sleep, regardless of indication. Participant hospital discharge records were reviewed through 2019 for ICD codes indicating incident falls. Propensity score matching was used to match participants who used sleep medications with those who did not (1:2). Cox proportional hazards regression models were used to assess the association of sleep medication use with falls with adjustment for demographics, lifestyle, and health characteristics.

Results: In the matched sample (N = 4794; 70% female; mean age 75.5 ± 5 years), 1200 documented falls occurred over 6.5 years of follow-up. In fully adjusted models, sleep medication use was associated with a 33% greater risk of falls compared to nonuse (HR: 1.33; 95% CI: 1.18-1.51). Results did not differ by age, sex, depressive symptoms, baseline cognitive status, or physical functioning status (interaction p-values >.05).

Conclusions: Late-life sleep medication use is associated with a higher risk of falls. Further research is needed to clarify the mechanisms linking sleep medications to falls risk.