Caring for elderly loved ones, especially those with neurocognitive disorders, is a journey filled with challenges and concerns. One significant aspect of this care is managing medications, such as antipsychotic drugs and cholinesterase inhibitors.

Recent research sheds light on the potential risks these medications pose in increasing the likelihood of falls and fractures in the elderly.

Study Overview

A self-controlled case series conducted using Taiwan’s National Health Insurance Database examined the risk of falls and fractures among 15,278 adults aged 65 and over.

These individuals were newly prescribed antipsychotic drugs and cholinesterase inhibitors and had experienced an incident fall or fracture between 2006 and 2017.

The study aimed to evaluate the association between these medications and the risk of falls and fractures in this demographic.

Significant Findings

The study’s results revealed a nuanced view of the risks associated with these medications:

  • The incidence of falls and fractures was considerably higher during the 14-day pretreatment period (52.35 per 100 person/years) compared to the non-treatment period (8.30 per 100 person/years).
  • During treatment periods, the risk of falls and fractures increased but was lower than during the pretreatment period. This included the use of a combination of cholinesterase inhibitors and antipsychotic drugs (adjusted incidence rate ratio 1.35), antipsychotic drugs alone (1.33), and cholinesterase inhibitors alone (1.17).

Implications for Elderly Care

Implications for Elderly Care - Safe Therapeutics

These findings suggest that while the risk of falls and fractures increases with the use of antipsychotic drugs and cholinesterase inhibitors, the highest risk occurs before treatment, indicating that underlying health conditions might contribute significantly to these risks.

Risk Management and Prevention

Understanding these risks is crucial for families and caregivers. It highlights the importance of:

  • Comprehensive assessment and regular review of medication regimens.
  • In-depth discussions with healthcare providers about the potential risks of these drugs.
  • Implementation of preventive measures, including home modifications, physical therapy, and close monitoring of the elderly when initiating or adjusting medication.


As we navigate the complex landscape of elderly care, particularly for those with neurocognitive disorders, understanding and managing medication risks is vital. This study provides valuable insights into the risks associated with antipsychotic drugs and cholinesterase inhibitors. By staying informed and proactive, we can ensure the safety and well-being of our elderly loved ones.

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