Abstract
Introduction Alcohol excess is a risk factor for falls in all ages. However, it is important to establish the relationship in older patients, who are at a greater risk of falling, to allow for appropriate risk management. Methods The Older Persons Assessment Service (OPAS) is an Emergency Department service which, accepting patients on the basis of the presence of frailty syndromes in patients aged >70 years (falls, confusion, care dependence, polypharmacy and poor mobility).The OPAS databank was retrospectively analysed for people with alcohol excess admitted with a fall between June 2020-December 2022. We examined clinical outcomes relating to medication, age, Charlson Co-morbidity index (CCI) and clinical frailty score (CFS). Alcohol Excess was defined by regularly exceeding government guidelines (>14 units a week). We applied the POSAMINO (Potentially Serious Alcohol–Medication Interactions in Older adults) criteria to our database to identify potentially inappropriate medications (PIMS). Results 1067 consecutive patients presenting with falls with 55 (0.05%) having a history of chronic alcohol excess; 3 with acute intoxication at the time of presentation on a background of chronic misuse. Those who presented with alcohol excess were younger (76.5 years (±9.5) vs 84.5 (±7.5) p<0.001) and less frail as per CFS (4.9 (±1.1) vs 5.3 (±1.3) p<0.05). There was a trend towards greater CCI (5.9 (±2.4) vs 5.6 (±1.9) p=0.13) in those who drink more alcohol. There was no significant difference in gender or mortality between the groups. When applying the POSAMINO criteria, the overall number of PIMS identified was 1.7 (±1.4), with those PIMS contributing to increased falls of 1.2 (±1.2). Conclusion Alcohol consumption is associated with an increased risk of falls in older adults. Increased awareness of the POSAMINO criteria can aid clinician de-prescribing decisions, especially in this cohort who are more vulnerable for recurrent falls.