Psychotropic drug-induced falls in older people: A review of interventions aimed at reducing the problem

Drugs and Aging

Volumn 29, Issue 1, 2012, Pages 15-30

  Hill, Keith D ^a,b,c   Wee, Rohan ^c  

^a LA TROBE UNIVERSITY   (Australia)

^b NATIONAL AGEING RESEARCH INSTITUTE   (Australia)

^c NORTHERN HEALTH   (Australia)

Author keywords

Antidepressants; Antipsychotics; Elderly; Hypnosedatives; Injuries

Indexed keywords

ANTIDEPRESSANT AGENT; ANXIOLYTIC AGENT; ATYPICAL ANTIPSYCHOTIC AGENT; BENZODIAZEPINE DERIVATIVE; CARBAMAZEPINE; DONEPEZIL; GALANTAMINE; HYPNOTIC AGENT; LAMOTRIGINE; LITHIUM; MEMANTINE; MONOAMINE OXIDASE INHIBITOR; NEUROLEPTIC AGENT; NORADRENALIN UPTAKE INHIBITOR; PSYCHOTROPIC AGENT; RIVASTIGMINE; SEROTONIN NORADRENALIN REUPTAKE INHIBITOR; SEROTONIN UPTAKE INHIBITOR; TRICYCLIC ANTIDEPRESSANT AGENT; VALPROIC ACID;

ALCOHOL WITHDRAWAL; ANXIETY DISORDER; BIPOLAR DISORDER; BLURRED VISION; CINAHL; DEMENTIA; DEPRESSION; DRUG SAFETY; DRUG TOLERABILITY; EPILEPSY; FALL RISK ASSESSMENT; FALLING; FATIGUE; FRACTURE; GERIATRIC PATIENT; HUMAN; INSOMNIA; MANIA; MEDICAL PRACTICE; MEDICAL RESEARCH; MEDLINE; OBSESSIVE COMPULSIVE DISORDER; PANIC; PATIENT MONITORING; PRIORITY JOURNAL; RESIDENTIAL CARE; REVIEW; SEIZURE; SIDE EFFECT; TREATMENT INDICATION; TREATMENT OUTCOME; TREMOR; VERTIGO; WITHDRAWAL SYNDROME;

ACCIDENTAL FALLS; AGED; FRACTURES, BONE; HUMANS; PSYCHOTROPIC DRUGS; RISK;

EID: 84255204768     PISSN: 1170229X     EISSN: 11791969     Source Type: Journal    
DOI: 10.2165/11598420-000000000-00000     Document Type: Review

References (113)

1. Lord S, Ward J, Williams P, et al. An epidemiological study of falls in older community-dwelling women: the Randwick falls and fractures study.Aust J Public Health 1993; 17: 240-5 (Pubitemid 23355798)
2. Kannus P, Parkkari J, Sievanen H, et al. Epidemiology of hip fractures. Bone 1996 Jan; 18 (1 Suppl.): 57S-63S (Pubitemid 26047545)
3. OLoughlin JL, Robitaille Y, Boivin JF, et al. Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. Am J Epidemiol 1993 Feb 1; 137 (3): 342-54 (Pubitemid 23090468)
4. Todd C, Skelton D. What are the main risk factors for falls among older people and what are the most effective interventions to prevent these falls? Copenhagen: World Health Organisation Regional Office for Europe (Health Evidence Network report), 2004
5. Campbell A, Reinken J, Allan B, et al. Falls in old age: a study of frequency and related clinical factors. Age Ageing 1981; 10 (4): 264-70 (Pubitemid 12233553)
6. Cassell E, Clapperton A. Preventing injury in Victorian seniors aged 65 years and older. Melbourne: Monash University Accident Research Centre, Victorian Injury Surveillance Unit (VISU), 2008
7. Cameron I, Murray G, Gillespie L, et al. Interventions for preventing falls in older people in nursing care facilities and hospitals. Cochrane Database Syst Rev 2010 Jan 20; (1): CD005465
8. Gillespie L, Robertson M, Gillespie W, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2009 Apr 15; (2): CD007146
9. Kreisfeld R, Harrison J. Hospital separations due to injury and poisoning 2005-06. Canberra (ACT): Australian Institute of Health and Welfare (AIHW), 2010
10. Kannus P, Niemi S, Parkkari J, et al. Epidemiology of adulthood injuries: a quickly changing injury profile in Finland. J Clin Epidemiol 2001; 54: 597-602 (Pubitemid 32453353)
11. Moller J. Projected costs of falls related injury to older persons due to demographic change in Australia. Report to the Commonwealth Department of Health and Ageing, under the National Falls Prevention for Older People Initiative. Canberra (ACT): Department of Communications, Information Technology and the Arts, Commonwealth of Australia, 2003
12. White SM, Griffiths R. Projected incidence of proximal femoral fracture in England: a report from the NHS Hip Fracture Anaesthesia Network (HIPFAN). Injury 2011 Nov; 42 (11): 1230-3
13. Kannus P, Niemi S, Parkkari J, et al. Hip fractures in Finland between 1970 and 1997 and predictions for the future. Lancet 1999; 353 (9155): 802-5 (Pubitemid 29110406)
14. Wilson RT, Chase GA, Chrischilles EA, et al. Hip fracture risk among community-dwelling elderly people in the United States: a prospective study of physical, cognitive, and socioeconomic indicators. Am J Public Health 2006 Jul; 96 (7): 1210-8 (Pubitemid 43967846)
15. Bentler SE, Liu L, Obrizan M, et al. The aftermath of hip fracture: discharge placement, functional status change, and mortality. Am J Epidemiol 2009 Nov 15; 170 (10): 1290-9
16. Magaziner J, Hawkes W, Hebel JR, et al. Recovery from hip fracture in eight areas of function. J Gerontol A Biol Sci Med Sci 2000 Sep; 55 (9): M498-507 (Pubitemid 32010275)
17. Wehren LE, Magaziner J. Hip fracture: risk factors and outcomes. Curr Osteoporos Rep 2003; 1 (2): 78-85
18. Scheffer AC, Schuurmans MJ, van Dijk N, et al. Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age Ageing 2008 Jan; 37 (1): 19-24 (Pubitemid 351146971)
19. Murphy SL, Williams CS, Gill TM. Characteristics associated with fear of falling and activity restriction in community- living older persons. J Am Geriatr Soc 2002 Mar; 50 (3): 516-20 (Pubitemid 34229409)
20. Lord S, Sherrington C, Menz H, et al. Falls in older people: risk factors and strategies for prevention. 2nd ed. Cambridge: Cambridge University Press, 2007
21. Bloch F, Thibaud M, Dugué B, et al. Psychotropic drugs and falls in the elderly people: updated literature review and meta-analysis. J Aging Health 2011; 23 (2): 329-46
22. Preville M, Hebert R, Boyer R, et al. Correlates of psychotropic drug use in the elderly compared to adults aged 18-64: results from the Quebec Health Survey. Aging Ment Health 2001 Aug; 5 (3): 216-24 (Pubitemid 32845615)
23. Mann E, Kopke S, Haastert B, et al. Psychotropic medication use among nursing home residents in Austria: a cross-sectional study. BMC Geriatr 2009 May 21; 9: 18
24. Gobert M, DHoore W. Prevalence of psychotropic drug use in nursing homes for the aged in Quebec and in the French-speaking area of Switzerland. Int J Geriatr Psychiatry 2005 Aug; 20 (8): 712-21 (Pubitemid 41158715)
25. Hilmer S, Mager D, Simonsick E, et al. A drug burden index to define the functional burden of medications in older people. Arch Intern Med 2007; 167 (8): 781-7 (Pubitemid 46658335)
26. Psychotropic Expert Group. Therapeutic guidelines: psychotropic. Version 6. Melbourne (VIC): Therapeutic Guidelines Limited, 2008
27. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed, text revision (DSMIV-TR). Arlington (VA): American Psychiatric Association, 2000
28. Smoller JW, Allison M, Cochrane BB, et al. Antidepressant use and risk of incident cardiovascular morbidity and mortality among postmenopausal women in the Womens Health Initiative study. Arch Intern Med 2009 Dec 14; 169 (22): 2128-39
29. Jorm AF, Grayson D, Creasey H, et al. Long-term benzodiazepine use by elderly people living in the community. Aust N Z J Public Health 2000 Feb; 24 (1): 7-10 (Pubitemid 30113593)
30. Voyer P, Preville M, Cohen D, et al. The prevalence of benzodiazepine dependence among community-dwelling older adult users in Quebec according to typical and atypical criteria. Can 2010; 29 (2): 205-13
31. Conn DK, Madan R. Use of sleep-promoting medications in nursing home residents: risks versus benefits. Drugs Aging 2006; 23 (4): 271-87 (Pubitemid 43830659)
32. Petrovic M, Mariman A, Warie H, et al. Is there a rationale for prescription of benzodiazepines in the elderly? Review of the literature. Acta Clin Belg 2003 Jan-Feb; 58 (1): 27-36 (Pubitemid 36396266)
33. Boyle N, Naganathan V, Cumming RG. Medication and falls: risk and optimization. Clin Geriatr Med 2010 Nov; 26 (4): 583-605
34. Johnsen E, Jørgensen HA. Effectiveness of second generation antipsychotics: a systematic review of randomized trials. BMC Psychiatry 2008; 8: 31
35. Tandon R. Safety and tolerability: how do newer generation atypical antipsychotics compare? Psychiatr Q 2002; 73 (4): 297-311 (Pubitemid 38429494)
36. Landi F, Onder G, Cesari M, et al. Psychotropic medications and risk for falls among community-dwelling frail older people: an observational study. J Gerontol A Biol Sci Med Sci 2005 May; 60 (5): 622-6 (Pubitemid 40847931)
37. Weiner DK, Hanlon JT, Studenski SA. Effects of central nervous system polypharmacy on falls liability in community- dwelling elderly. Gerontology 1998; 44 (4): 217-21 (Pubitemid 28305943)
38. Woolcott JC, Richardson KJ, Wiens MO, et al. Metaanalysis of the impact of 9 medication classes on falls in elderly persons. Arch Intern Med 2009 Nov 23; 169 (21): 1952-60
39. Deandrea S, Lucenteforte E, Bravi F, et al. Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology 2010; 21 (5): 658-68
40. Vestergaard P. Skeletal effects of central nervous system active drugs: anxiolytics, sedatives, antidepressants, lithium and neuroleptics. Cur Drug Saf 2008; 3 (3): 185-9
41. Richards JB, Papaioannou A, Adachi JD, et al. Effect of selective serotonin reuptake inhibitors on the risk of fracture. Arch Intern Med 2007 Jan 22; 167 (2): 188-94 (Pubitemid 46148067)
42. Cumming R, Le Couteur D. Benzodiazepines and risk of hip fractures in older people: a review of the evidence. CNS Drugs 2003; 17 (11): 825-37 (Pubitemid 37082985)
43. van der Hooft C, Schoofs M, Ziere G, et al. Inappropriate benzodiazepine use in older adults and the risk of fracture. Br J Clin Pharmacol 2008; 66 (2): 276-82
44. Ginzburg R, Rosero E. Risk of fractures with selective serotonin-reuptake inhibitors or tricyclic antidepressants. Ann Pharmacother 2009; 43 (1): 98-103
45. Draper B, Berman K. Tolerability of selective serotonin reuptake inhibitors: issues relevant to the elderly. Drugs Aging 2008; 25 (6): 501-19 (Pubitemid 351812258)
46. Wang P, Bohn R,Glynn R, et al. Hazardous benzodiazepine regimens in the elderly: effects of half-life, dosage, and duration on risk of hip fracture. Am J Psychiatry 2001; 158 (6): 892-8 (Pubitemid 32547618)
47. Wu Q, Liu J, Gallegos-Orozco J, et al. Depression, fracture risk, and bone loss: a meta-analysis of cohort studies. Osteoporos Int 2010; 21 (10): 1627-35
48. Pariente A, Dartigues JF, Benichou J, et al. Benzodiazepines and injurious falls in community dwelling elders. Drugs Aging 2008; 25 (1): 61-70
49. Panneman MJ, Goettsch WG, Kramarz P, et al. The costs of benzodiazepine-associated hospital-treated fall injuries in the EU: a Pharmo study. Drugs Aging 2003; 20 (11): 833-9 (Pubitemid 37159600)
50. Kerse N, Flicker L, Pfaff JJ, et al. Falls, depression and antidepressants in later life: a large primary care appraisal. PLoS One 2008; 3 (6): e2423
51. Diem SJ, Blackwell TL, Stone KL, et al. Use of antidepressants and rates of hip bone loss in older women: the study of osteoporotic fractures. Arch Intern Med 2007 Jun 25; 167 (12): 1240-5 (Pubitemid 46998494)
52. Rossi S, editor. Australian medicines handbook 2011. 11th ed. Adelaide (SA): Australian Medicines Handbook Pty. Limited, 2011
53. Ensrud KE, Blackwell TL, Mangione CM, et al. Central nervous system-active medications and risk for falls in older women. J Am Geriatr Soc 2002 Oct; 50 (10): 1629-37 (Pubitemid 35192533)
54. Petty SJ, Hill KD, Haber NE, et al. Balance impairment in chronic antiepileptic drug users: a twin and sibling study. Epilepsia 2009; 51 (2): 280-8
55. Leipzig R, Cumming R, Tinetti M. Drugs and falls in older people: a systematic review and meta-analysis: I. Psychotropic drugs. J Am Geriatr Soc 1999; 47: 30-9 (Pubitemid 29044264)
56. Berdot S, Bertrand M, Dartigues JF, et al. Inappropriate medication use and risk of falls: a prospective study in a large community-dwelling elderly cohort. BMC Geriatr 2009 Jul 23; 9: 30
57. Lord SR, Anstey KJ, Williams P, et al. Psychoactive medication use, sensori-motor function and falls in older women. Br J Clin Pharmacol 1995 Mar; 39 (3): 227-34
58. Ray WA, Thapa PB, Gideon P. Benzodiazepines and the risk of falls in nursing home residents. J Am Geriatr Soc 2000 Jun; 48 (6): 682-5 (Pubitemid 30390461)
59. Golden AG, Ma Q, Nair V, et al. Risk for fractures with centrally acting muscle relaxants: an analysis of a national Medicare Advantage claims database. Ann Pharmacother 2010; 44 (9): 1369-75
60. Passaro A, Volpato S, Romagnoni F, et al. Benzodiazepines with different half-life and falling in a hospitalized population: the GIFA study. Gruppo Italiano di Farmacovigilanza nellAnziano. J Clin Epidemiol 2000 Dec; 53 (12): 1222-9 (Pubitemid 32007838)
61. Ray WA, Thapa PB, Gideon P. Misclassification of current benzodiazepine exposure by use of a single baseline measurement and its effects upon studies of injuries. Pharmacoepidemiol Drug Saf 2002 Dec; 11 (8): 663-9 (Pubitemid 35469361)
62. Horikawa E, Matsui T, Arai H, et al. Risk of falls in Alzheimers disease: a prospective study. Intern Med 2005 Jul; 44 (7): 717-21 (Pubitemid 41093824)
63. Chung KA, Lobb BM, Nutt JG, et al. Effects of a central cholinesterase inhibitor on reducing falls in Parkinson disease. Neurology 2010; 75 (14): 1263-9
64. Mehta S, Chen H, Johnson ML, et al. Risk of falls and fractures in older adults using antipsychotic agents: a propensity-matched retrospective cohort study. Drugs 2010; 27 (10): 815-29
65. Kallin K, Gustafson Y, Sandman PO, et al. Drugs and falls in older people in geriatric care settings. Aging Clin Exp Res 2004 Aug; 16 (4): 270-6 (Pubitemid 39496918)
66. Ballard C, Cream J. Drugs used to relieve behavioral symptoms in people with dementia or an unacceptable chemical cosh? Argument. Int Psychogeriatr 2005 Mar; 17 (1): 4-12; discussion 22-9 (Pubitemid 40593642)
67. Campbell A, Robertson M, Gardner M, et al. Psychotropic medication withdrawal and a home based exercise program to prevent falls: a randomised controlled trial. J Am Geriatr Soc 1999; 47 (7): 850-3 (Pubitemid 29326016)
68. Patterson S, Hughes C, Crealey G, et al. An evaluation of an adapted U.S. model of pharmaceutical care to improve psychoactive prescribing for nursing home residents in Northern Ireland (Fleetwood Northern Ireland Study). J Am Geriatr Soc 2010; 58: 44-53
69. Weber V, White A, McIlvried R. An electronic medical record (EMR)-based intervention to reduce polypharmacy and falls in an ambulatory rural elderly population. J Gen Intern Med 2008 Apr; 23 (4): 399-404 (Pubitemid 351464872)
70. Pit SW, Byles JE, Henry DA, et al. A Quality Use of Medicines program for general practitioners and older people: a cluster randomised controlled trial. Med J Aust 2007 Jul 2; 187 (1): 23-30 (Pubitemid 47082734)
71. Midlöv P, Bondesson A, Eriksson T, et al. Effects of educational outreach visits on prescribing of benzodiazepines and antipsychotic drugs to elderly patients in primary health care in southern Sweden. Fam Pract 2006 23(1): 60-4
72. Findlay D, Sharma J, McEwen J, et al. Double-blind controlled withdrawal of thioridazine treatment in elderly female inpatients with senile dementia. Int J Geriatr Psychiatry 1989; 4: 115-20 (Pubitemid 19079145)
73. Cohen-Mansfield J, Lipson S, Werner P, et al. Withdrawal of haloperidol, thioridazine, and lorazepam in the nursing home: a controlled, double-blind study. Arch Intern Med 1999; 159 (15): 1733-40 (Pubitemid 29379136)
74. Ruths S, Straand J, Nygaard H, et al. Effect of antipsychotic withdrawal on behavior and sleep/wake activity in nursing home residents with dementia: a randomized, placebocontrolled, double-blinded study. The Bergen District Nursing Home Study. J Am Geriatr Soc 2004; 52 (10): 1737-43 (Pubitemid 41709930)
75. van Reekum R, Clarke D, Conn D, et al. A randomized, placebo-controlled trial of the discontinuation of longterm antipsychotics in dementia. Int Psychogeriatr 2002; 14 (2): 197-210
76. Ten Wolde G, Dijkstra A, van Empelen P, et al. Long-term effectiveness of computer-generated tailored patient education on benzodiazepines: a randomized controlled trial. Addiction 2008; 103 (4): 662-70 (Pubitemid 351389283)
77. Habraken H, Soenen K, Blondeel L, et al. Gradual withdrawal from benzodiazepines in residents of homes for the elderly: experience and suggestions for future research. Eur J Clin Pharmacol 1997; 51 (5): 355-8 (Pubitemid 27055901)
78. van Eijk M, Avorn J, Porsius A, et al. Reducing prescribing of highly anticholinergic antidepressants for elderly people: randomised trial of group versus individual academic detailing. BMJ 2001; 322 (7287): 654-7 (Pubitemid 32234502)
79. Ulfvarson J, Adami J, Wredling R, et al. Controlled withdrawal of selective serotonin reuptake inhibitor drugs in elderly patients in nursing homes with no indication of depression. Eur J Clin Pharmacol 2003; 59 (10): 735-40 (Pubitemid 38041297)
80. Minett T, Thomas A, Wilkinson L, et al. What happens when donepezil is suddenly withdrawn? An open label trial in dementia with Lewy bodies and Parkinsons disease with dementia. Int J Geriatr Psychiatry 2003; 18 (11): 988-93 (Pubitemid 37479370)
81. Ballard C, Hanney ML, Theodoulou M, et al. The Dementia Antipsychotic Withdrawal Trial (DART-AD): long-term follow-up of a randomised placebo-controlled trial. Lancet Neurol 2009 Feb; 8 (2): 151-7
82. Rikala M, Korhonen M, Sulkava R, et al. The effects of medication assessment on psychotropic drug use in the community-dwelling elderly. Int Psychogeriatr 2011; 23 (3): 473-84
83. Hill A, Hoffmann T, Hill K, et al. Measuring falls events in acute hospitals-a comparison of three reporting methods to identify missing data in the hospital reporting system. J Am Geriatr Soc 2010; 58 (7): 1347-52
84. Lamb S, Jørstad-Stein E, Hauer K, et al., Prevention of Falls Network Europe and Outcomes Consensus Group. Development of a common outcome data set for fall injury prevention trials: the Prevention of Falls Network Europe consensus. J Am Geriatr Soc 2005; 53 (9): 1618-22 (Pubitemid 41602457)
85. Meredith S, Feldman P, Frey D, et al. Improving medication use in newly admitted home healthcare patients: a randomized controlled trial. J Am Geriatr Soc 2002; 50 (9): 1484-91 (Pubitemid 35024639)
86. Zermansky AG, Alldred DP, Petty DR, et al. Clinical medication review by a pharmacist of elderly people living in care homes: randomised controlled trial. Age Ageing 2006 Nov; 35 (6): 586-91 (Pubitemid 44614153)
87. Crotty M, Rowett D, Spurling L, et al. Does the addition of a pharmacist transition coordinator improve evidencebased medication management and health outcomes in older adults moving from the hospital to a long-term care facility? Results of a randomized, controlled trial. Am J Geriatr Pharmacother 2004; 2 (4): 257-64 (Pubitemid 40378780)
88. Nishtala P, McLachlan A, Bell J, et al. Psychotropic prescribing in long-term care facilities: impact of medication reviews and educational interventions. Am J Geriatr Psychiatry 2008; 16 (8): 621-32
89. Oude Voshaar R, Gorgels W, Mol A, et al. Tapering off long-term benzodiazepine use with or without group cognitive-behavioural therapy: three-condition, randomised controlled trial. Br J Psychiatry 2003; 182: 498-504 (Pubitemid 36649195)
90. Salzman C, Nobel K, Fisher J, et al. Cognitive improvement following benzodiazepine discontinuation in elderly nursing home residents. Int J Geriatr Psychiatry 1992; 7 (7): 89-93
91. Curran H, Collins R, Fletcher S, et al. Older adults and withdrawal from benzodiazepine hypnotics in general practice: effects on cognitive function, sleep, mood and quality of life. Psychol Med 2003; 33 (7): 1223-37 (Pubitemid 37265211)
92. Lindsey PL. Psychotropic medication use among older adults: what all nurses need to know. J Gerontol Nurs 2009 Sep; 35 (9): 28-38
93. Australian Commission on Safety and Quality in Healthcare (ACSQHC). Preventing falls and harm from falls in older people: best practice guidelines for Australian community care. Canberra (ACT): ACSQHC, Commonwealth of Australia, 2009
94. Australian Commission on Safety and Quality in Healthcare (ACSQHC). Preventing falls and harm from falls in older people: best practice guidelines for Australian residential aged care facilities. Canberra (ACT): Australian ACSQHC, Commonwealth of Australia, 2009
95. Australian Commission on Safety and Quality in Healthcare (ACSQHC). Preventing falls and harm from falls in older people: best practice guidelines for Australian hospitals. Canberra (ACT): ACSQHC, Commonwealth of Australia, 2009
96. National Collaborating Centre for Nursing and Supportive Care. Clinical practice guideline for the assessment and prevention of falls in older people: guidelines commissioned by the National Institute for Clinical Excellence (NICE) [clinical guideline 21]. London: Royal College of Nursing, 2004
97. Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society. Summary of the updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc 2011 Jan 59 (1): 148-57
98. Ballard C, Gauthier S, Cummings J, et al. Management of agitation and aggression associated with Alzheimer disease. Nat Rev Neurol 2009; 5 (5): 245-55
99. Hendriks G, Oude Voshaar R, Keijsers G, et al. Cognitivebehavioural therapy for late-life anxiety disorders: a systematic review and meta-analysis. Acta Psychiatr Scand 2008; 117 (6): 403-11 (Pubitemid 351678477)
100. Oude Voshaar R, Couvée J, van Balkom A, et al. Strategies for discontinuing long-term benzodiazepine use: metaanalysis. Br J Psychiatry 2006; 189: 213-20 (Pubitemid 44343465)
101. National Ageing Research Institute and Melbourne Extended Care and Rehabilitation Service. Falls risk for older people - community setting (FROP-Com). Parkville (VIC): National Ageing Research Institute (NARI) [online]. Available from URL: http://www.mednwh.unimelb. edu.au/research/pdf-docs/ FropCom2009/Falls-risk-for-ol der-people-community-setting-09.pdf [Accessed 2011 Oct 31]
102. Russell MA, Hill KD, Blackberry I, et al. The reliability and predictive accuracy of the falls risk for older people in the community assessment (FROP-Com) tool. Age Ageing 2008 Nov; 37 (6): 634-9
103. Fallscreen: the falls risk calculator. Randwick (NSW): Neuroscience Research Australia [online]. Available from URL: http://www.neura.edu.au/index. php?q=FBRG/# The-physiological-assessments [Accessed 2011 Oct 31]
104. Lord SR, Menz HB, Tiedemann A. A physiological profile approach to falls risk assessment and prevention. Phys Ther 2003 Mar; 83 (3): 237-52 (Pubitemid 36348983)
105. Dollman WB, Leblanc VT, Stevens L, et al. Achieving a sustained reduction in benzodiazepine use through implementation of an area-wide multi-strategic approach. J Clin Pharm Ther 2005 Oct; 30 (5): 425-32 (Pubitemid 41603015)
106. Dahl LJ, Wright R, Xiao A, et al. Quality improvement in long term care: the psychotropic assessment tool (PAT). J Am Med Dir Assoc 2008 Nov; 9 (9): 676-83
107. Lampe L. Antidepressants: not just for depression. Aust Prescr 2005; 28 (4): 91-3
108. Forsman AK, Schierenbeck I, Wahlbeck K. Psychosocial interventions for the prevention of depression in older adults: systematic review and meta-analysis. J Aging Health 2011; 23 (3): 387-416
109. Krogh J, Nordentoft M, Sterne JA, et al. The effect of exercise in clinically depressed adults: systematic review and meta-analysis of randomized controlled trials. J Clin Psychiatry 2011; 72 (4): 529-38
110. Windle G, Hughes D, Linck P, et al. Is exercise effective in promoting mental well-being in older age? A systematic review. Aging Ment Health 2010 Aug; 14 (6): 652-69
111. Smith AJ, Tett SE. An intervention to improve benzodiazepine use: anew approach. Fam Pract 2010 Jun; 27 (3): 320-7
112. Smith AJ, Tett SE. Interventions to improve benzodiazepine prescribing, lessons from the past 20 years to guide future interventions. BMC Health Serv Res 2010; 10 (1): 321
113. Cook JM, Marshall R, Masci C, et al. Physicians perspectives on prescribing benzodiazepines for older adults: a qualitative study. J Gen InternMed 2007Mar; 22 (3): 303-7 (Pubitemid 46941221)