Many older adults leave the hospital with new medicines to help them recover.
While these medicines are often prescribed with good intentions, a large new study suggests that some commonly used sedative drugs may increase the risk of serious problems soon after patients return home.
Researchers found that older adults who received a new prescription for sedatives, especially benzodiazepines or antipsychotic medicines, were more likely to fall, return to hospital, or even die within the first month after discharge. The findings were published in the Canadian Medical Association Journal.
As people age, their bodies become more sensitive to many medicines. Drugs that cause drowsiness, slower thinking, poor balance, or dizziness can be especially risky.
Benzodiazepines are often prescribed to treat anxiety, insomnia, or agitation, while antipsychotic medicines may be used for severe confusion, behavioral symptoms, or certain mental health conditions.
Although these medicines can be helpful in selected situations, experts have long warned that they should be used carefully in older adults because of their side effects.
To better understand the risks, researchers from Mount Sinai Hospital, Sinai Health, the University of Toronto, and colleagues examined health records from more than 1.86 million adults aged 66 years and older. The study included people discharged from hospital between April 2003 and August 2023 using health data collected by ICES in Canada.
The researchers found that about 13 percent of patients filled a prescription for a sedative within seven days after leaving hospital. Around one-third of these people had not been taking these medicines during the previous six months, meaning the medication was newly started at discharge.
The results showed that people who received a new sedative prescription faced a 20 percent higher risk of falls requiring medical care. They were also more likely to visit the emergency department, be readmitted to hospital, or die within 30 days. Interestingly, patients who had already been taking these medicines before hospital admission did not show the same increase in risk.
Falls are one of the leading causes of injury among older adults. They can result in broken bones, head injuries, loss of independence, and long recovery periods. Even a single fall may permanently affect an older person’s ability to live independently.
The researchers believe doctors should carefully consider whether a new sedative is truly necessary before hospital discharge. If the medicine cannot be avoided, patients should receive close follow-up within one or two weeks. Medication reviews, fall prevention programs, mobility assessments, and family support may also help reduce harm.
One major strength of this research is its enormous sample size, making the findings highly reliable for real-world practice. However, because this was an observational study, it cannot prove the medicines directly caused every adverse outcome.
Patients receiving sedatives may also have been sicker than others. Even so, the consistent increase in risk supports current recommendations to prescribe these medicines cautiously and review them regularly after discharge.
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Source: Mount Sinai Hospital, Sinai Health and University of Toronto.
