Use of medications with anticholinergic activity and self-reported injurious falls in the older aged community-dwelling adults

Kathryn Richardson, Kathleen Bennett, Ian D. Maidment, Chris Fox, David Smithard, Rose Anne Kenny

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55 Citations (Scopus)


Objectives: To assess the association between the use of medications with anticholinergic activity and the subsequent risk of injurious falls in older adults.

Design: Prospective, population-based study using data from The Irish Longitudinal Study on Ageing.

Setting: Irish population.

Participants: Community-dwelling men and women without dementia aged 65 and older (N = 2,696).

Measurements: Self-reported injurious falls reported once approximately 2 years after baseline interview. Self-reported regular medication use at baseline interview. Pharmacy dispensing records from the Irish Health Service Executive Primary Care Reimbursement Service in a subset (n = 1,553).

Results: Nine percent of men and 17% of women reported injurious falls. In men, the use of medications with definite anticholinergic activity was associated with greater risk of subsequent injurious falls (adjusted relative risk (aRR) = 2.55, 95% confidence interval (CI) = 1.33–4.88), but the risk of having any fall and the number of falls reported were not significantly greater. Greater anticholinergic burden was associated with greater injurious falls risk. No associations were observed for women. Findings were similar using pharmacy dispensing records. The aRR for medications with definite anticholinergic activity dispensed in the month before baseline and subsequent injurious falls in men was 2.53 (95% CI = 1.15–5.54).

Conclusion: The regular use of medications with anticholinergic activity is associated with subsequent injurious falls in older men, although falls were self-reported after a 2-year recall and so may have been underreported. Further research is required to validate this finding in men and to consider the effect of duration and dose of anticholinergic medications.
Original languageEnglish
Pages (from-to)1561–1569
Number of pages9
JournalJournal of the American Geriatrics Society
Issue number8
Early online date22 Jul 2015
Publication statusPublished - Aug 2015


  • anticholinergic
  • antimuscarinic
  • falls
  • injury
  • elderly

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