Are Common Medications Increasing the Risk of Falls in Older Adults?

Falls are often treated as an unavoidable part of ageing, but for many older adults, a simple trip or loss of balance can have serious consequences. A fall can lead to fractures, hospitalisation, loss of independence and, in some cases, death.

Researchers have become increasingly interested in another possible contributor medication.

Certain commonly prescribed medicines may increase the likelihood of falling, particularly in older adults. These medicines are sometimes described as fall-risk-increasing drugs, or FRIDs. They include medications used to treat conditions such as high blood pressure, heart disease, depression, anxiety, insomnia and nerve pain.

As prescription drug use continues to rise, experts are asking an important question: could some medicines be contributing to the growing number of serious falls among older people?

Falls are becoming a growing health concern

Falls are already one of the leading causes of accidental injury worldwide. They are particularly concerning among older adults because ageing can affect balance, muscle strength, vision and reaction time.

Research published in 2025 examined fall-related deaths across 59 countries and found that the death rate increased from approximately 11 to 13 deaths per 100,000 people between 2009 and 2021.

The situation appears particularly serious among the oldest members of the population.

In the United States, for example, deaths following falls among people aged 85 and older have increased dramatically since 2000. In England, hospital emergency department admissions involving people aged over 65 who had fallen also increased substantially between 2011 and 2021.

These figures do not necessarily prove that people are falling more often everywhere. Changes in healthcare, reporting practices, population age and the number of people living with multiple health conditions may all contribute.

However, medication use is another factor researchers are investigating.

What are fall-risk-increasing drugs?

Fall-risk-increasing drugs are medications that can make a person more likely to lose their balance or become injured in a fall.

They can affect the body in several ways. Some cause drowsiness or slower reactions. Others can produce dizziness, confusion or weakness. Certain medicines can also lower blood pressure, particularly when a person stands up, potentially causing light-headedness or fainting.

These effects can be especially important in older adults.

As people age, the body can process medicines differently. Older adults are also more likely to take several medications at the same time. This combination, known as polypharmacy, can make it harder to determine how individual medicines or drug combinations are affecting balance and alertness.

Importantly, a medication that is perfectly appropriate for one person may create problems for another.

Which medications may increase fall risk?

There are several categories of medicines that have been associated with an increased risk of falls.

1. Benzodiazepines

Benzodiazepines are commonly prescribed for anxiety, insomnia and some other conditions. They can have sedating effects and may impair alertness, coordination and reaction time.

For an older person who is already experiencing balance problems, these effects may make a fall more likely.

2. Antidepressants

Antidepressants are widely used to manage depression and other mental health conditions. Some types have been associated with an increased risk of falls, particularly in older adults.

The relationship can be complicated because depression itself may affect sleep, concentration, physical activity and balance. This means doctors need to consider both the potential benefits of treatment and possible side effects.

3. Gabapentinoids

Gabapentinoid medications are often prescribed for nerve pain and certain neurological conditions. They can cause side effects such as dizziness, sleepiness and problems with coordination.

Public health experts have highlighted these medicines as an area of concern, particularly as their use has increased.

4. Blood pressure medications

Medicines used to control high blood pressure can sometimes lower blood pressure more than intended, particularly when someone moves quickly from sitting or lying down to standing.

This can cause a temporary drop in blood pressure known as orthostatic hypotension. Symptoms may include dizziness, weakness or feeling faint, potentially increasing the risk of falling.

However, controlling high blood pressure remains important for preventing serious cardiovascular problems. The goal is therefore not simply to stop these medicines, but to make sure treatment is appropriate for the individual.

Why taking several medications can be complicated

Many older adults live with multiple health conditions, meaning they may need several prescriptions.

One person could be taking medication for high blood pressure, another for heart disease and another for anxiety, pain or sleep problems. When several medicines are taken together, their effects can sometimes overlap.

For example, two medications may each cause mild dizziness. Taken together, the effect could become more noticeable.

This is one reason medication reviews can be important for older adults who experience repeated falls, unexplained dizziness or sudden changes in balance.

However, stopping a prescription is not always straightforward.

A medication may have been prescribed by a specialist for an important medical condition, while another doctor may be responsible for a different aspect of the patient's care. Reviewing and reducing medicines therefore requires careful coordination.

Should older adults stop taking these medicines?

No. Medication should never be stopped suddenly without medical advice.

Although some drugs may increase fall risk, they can also provide important benefits. For example, a medicine may control blood pressure, reduce nerve pain, manage depression or prevent another serious medical problem.

Stopping certain medications abruptly can also cause withdrawal symptoms or allow the underlying condition to return or worsen.

Instead, people who are concerned about falls should speak with a doctor, pharmacist or other qualified healthcare professional. They may be able to review the person's prescriptions, check for potentially problematic combinations and determine whether doses or treatments need to be adjusted.

Medication is only one piece of the puzzle

It is important not to assume that medication is responsible for every fall.

Age-related muscle loss, poor eyesight, balance problems, unsuitable footwear, environmental hazards, dehydration and certain medical conditions can all contribute.

Simple measures can also help reduce risk. Improving lighting around the home, removing loose rugs and obstacles, installing appropriate handrails and maintaining physical strength and balance can all be useful.

For someone who has already experienced a fall, identifying the underlying cause is particularly important.

What does the research tell us?

Evidence linking some medications with falls is becoming stronger, but important questions remain.

Some studies have suggested that reducing or stopping potentially inappropriate medications does not always produce a large reduction in falls. This does not necessarily mean that medication has no role. It may indicate that falls have multiple causes and that changing prescriptions alone cannot eliminate the risk.

More research is needed to understand which medications pose the greatest risk, how combinations of medicines affect older adults and which interventions are most effective.

For now, experts recommend taking a balanced approach.

The key question should not simply be whether an older person takes a particular medication. Instead, healthcare professionals need to consider the individual's health, medication combinations, dosage, side effects, fall history and overall quality of life.

The bottom line

Falls among older adults are a serious and growing health concern. While there is no single explanation for the trend, certain commonly prescribed medicines may increase the risk by causing dizziness, sedation, confusion or changes in blood pressure.

Benzodiazepines, some antidepressants and gabapentinoids are among the medication groups attracting particular attention.

That does not mean these medicines are unsafe or unnecessary. For many people, they provide important health benefits. The important step is ensuring that prescriptions are regularly reviewed and that potential side effects are discussed with a healthcare professional.

If an older adult begins experiencing unexplained dizziness, excessive sleepiness, balance problems or repeated falls after starting or changing medication, it is worth seeking professional advice.

A medication review could be one part of a broader strategy to help older adults stay safer, healthier and independent for longer.

Sources

• British Medical Journal, research on fall-risk-increasing drugs and older adults.
• JAMA Health Forum, discussion of medication use and fall risk among older adults.
• PubMed, research on falls as a major cause of accidental injury and death.
• NHS data concerning emergency admissions involving older adults and falls.

Medical Disclaimer

This article is intended for general informational and educational purposes only. It is not medical advice and should not be used to diagnose, treat or prevent a health condition. Do not stop, reduce or change any prescription medication without speaking with a qualified healthcare professional. If you or someone you care for is experiencing repeated falls, dizziness, fainting, confusion or other concerning symptoms, seek appropriate medical advice.