A hospital stay is often followed by new medicines that are meant to help patients recover. However, a new Canadian study suggests that one group of medications deserves extra caution in older adults.
Researchers discovered that starting sedative medicines when leaving hospital may significantly increase the chance of falls and other serious health problems during the following month. The study appeared in the Canadian Medical Association Journal.
Sedatives include medicines that make people calmer or sleepier. Two important groups are benzodiazepines, commonly used for anxiety and sleep problems, and antipsychotic medicines, sometimes prescribed for confusion or severe behavioral symptoms.
These drugs can affect balance, coordination, reaction time, and alertness, making falls more likely, especially in older people.
The research team analyzed healthcare information from more than 1.86 million Canadians aged 66 years or older who had been discharged from hospital over a twenty-year period. They compared people who started a new sedative after leaving hospital with those who had already been taking these medicines before admission.
About 246,000 patients filled a sedative prescription within one week of discharge. More than 76,000 of them were completely new users.
This group experienced the highest risks. Their likelihood of suffering a fall serious enough to require medical attention was about 20 percent higher. They also had higher rates of emergency department visits, hospital readmissions, and death within 30 days.
One interesting finding was that people who had been using sedatives before their hospital stay did not experience the same increase in risk. This suggests that suddenly starting these medicines during a vulnerable recovery period may be especially hazardous.
Older adults often recover more slowly after illness or surgery. Weakness, reduced mobility, poor appetite, dehydration, and multiple medications can all increase the risk of falls. Adding a medicine that causes drowsiness or slower thinking may further increase that danger.
The researchers recommend that doctors think carefully before prescribing new sedatives at discharge. When these medicines are necessary, patients should have early follow-up appointments, regular medication reviews, and support to reduce fall risk at home.
This study benefits from exceptionally large real-world data collected over many years, making the results highly relevant to everyday medical practice.
Although observational studies cannot establish cause and effect, the findings strongly reinforce existing medical advice to avoid unnecessary sedatives in older adults whenever possible. Future studies may help identify which patients benefit from these medicines while minimizing the risks.
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Source: Mount Sinai Hospital, Sinai Health and University of Toronto.
