A maj
or Canadian study published in CMAJ reveals that new sedative prescriptions after hospital discharge significantly increase the risk of falls, emergency visits, readmissions, and death in older adults. The danger is greatest for patients who were not previously using sedatives, especially when prescribed benzodiazepines or antipsychotics. With more than 1.86 million older adults analyzed over 20 years, the findings underscore the urgent need for careful medication review, deprescribing, and fall‑prevention strategies during transitions from hospital to home.
CMAJ Study with Older Adults and Falls: Click here
Key Findings – Risk of Falls
1. Sedative prescribing is common
- 13.2% of older adults filled a sedative prescription within 7 days of discharge.
- 31% of these were sedative‑naive before admission.
2. New sedative use sharply increases adverse outcomes
- Falls: HR 1.20
- ED visits: HR 1.20
- Hospital readmission: HR 1.20
- Death: HR 1.78 These events typically occurred within the first 8–13 days post‑discharge.
3. Risk varies by sedative class
- Benzodiazepines: Increased risk for all outcomes in sedative‑naive patients; increased fall risk even in previously exposed patients.
- Antipsychotics: Increased risk of falls and death in sedative‑naive patients.
- Antidepressant sedatives (mirtazapine, trazodone): Associated with lower fall risk—an unexpected finding compared with prior literature.
Why This Matters
The early post‑discharge period is a high‑risk window for older adults. Sedatives—often used for sleep, anxiety, agitation, or delirium—can impair balance, cognition, and reaction time. When newly introduced after hospitalization, these effects compound acute illness recovery, frailty, and polypharmacy.
Learn more from our BCRPA approved Older Adult course and certification: Click here